xxxxxxxxxxxxxxxxxxxxx@xxxxxxxxxxxxxx.xxx  

 

DE00000396531

 

20 March 2009  

 

Dear Mr Taylor,

 

Thank you for your email of 9 March requesting, under the Freedom of Information Act, information relating to a Parliamentary Question asked by Baroness Tonge on 4 March 2009 about research commissioned on the removal of Clostridium difficile (Cl. difficile) spores from laundry.  I have been asked to reply.

 

i. Details of who has been awarded the contract/research grant

to carry out this research.

 

The research contract has been awarded to the Centre for Infectious Diseases & International Health, Windeyer Institute of Medical Sciences, University College London.

 

The research is also supported by industrial partners. This will allow for experimentation using large-scale laundry plant and equipment.

 

ii. The research protocol to be followed, along with details of any research proposals rejected.

 

The research protocol is based on the following:

 

The need to estimate the extent of Cl. difficile contamination on bed clothing after use, and to look at the effects of laundering in terms of deactivation and removal, thereby providing evidence on the adequacy or otherwise of the present laundry processes.

 

  1. Determination of the spore contamination levels on freshly laundered sheets

In order to validate the results of laboratory studies, sheets from patients with Cl. difficile associated disease (CDAD), routinely sent to a commercial laundry, will be assessed post laundry for contamination by Cl. difficile.

 

The sheets will be identified on the ward, bagged according to current procedures and dispatched to the laundry.  They will be laundered according to current HSG (95)18 guidelines before dispatch in a sealed sterile container to University College London where the level of contamination with Cl. difficile will be assessed.  The guidelines can be found on the Department’s website at: www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/Healthserviceguidelines/DH_4017865

 

  1. Swatch study using samples of known contaminated laundry materials, which have been passed through both laboratory washers and an industrial tunnel washer.

Patients may be colonised by toxigenic Cl. difficile yet not have symptoms and may act as a source of infection for others.  Sheets from these patients will normally be laundered in a tunnel washer as the laundry will not be categorized as foul or infected.  Therefore, it is necessary to assess the efficacy of laundry handled through a tunnel washer in removing Cl. difficle spores.  

 

Swatches, contaminated with 105-107  non-toxigenic Cl. difficile spores and sterile swatches (to determine any cross-contamination) will be added with ballast to a tunnel washer as part of a normal load and processed according to HSG (95) 18.  The swatches will be recovered and the contamination with Cl. difficile determined.  The laundry will also run their usual programme of contaminated swatches (E coli, E hirae) as a check on machine performance.

 

  1. Investigation on the effectiveness of a range of detergent chemistries in spore removal.

 

The spores of Cl.difficile may reside within the fabric of bed linen making them difficult to remove during laundering.  The retention of the spores may vary according to the fabric type.

 

Swatches of 100 per cent cotton and 50 per cent cotton/50 per cent polyester will be artificially contaminated with Cl. difficile spores the fabric will be examined by Scanning Electron Microscope both before and after laundry to assess the retention of the spores.

 

 

iii) If the research was commissioned following an open call for proposals or similar process, and if not, why not.

 

The project was commissioned as an extension of earlier work completed by the laboratory concerned in order to speed up this important research and build on existing knowledge and capability.

 

The contract was awarded through a single source tendering exercise, which followed the relevant Department of Health procurement procedures.

 

I hope you find this reply helpful.

 

If you have any queries about this letter, please contact me.  Please remember to quote the reference number above in any future communications.

 

If you are dissatisfied with the handling of your request, you have the right to ask for an internal review.  Internal review requests should be submitted within two months of the date of receipt of the response to your original letter and should be addressed to :

 

Freedom of Information Unit

Department of Health

Room 334b

Skipton House

80 London Road

SE1 6LH

 

Email:xxxxxxxxxxxxxxxxxxxx@xx.xxx.xxx.xx

 

If you are not content with the outcome of your complaint, you may apply directly to the Information Commissioner (ICO) for a decision.  Generally, the ICO cannot make a decision unless you have exhausted the complaints procedure provided by the Department.  The ICO can be contacted at:

 

The Information Commissioner’s Office

Wycliffe House

Water Lane

Wilmslow

Cheshire

SK9 5AF

 

Yours sincerely,

 

 

Woraphan Lagkam

Customer Service Centre

Department of Health