The clean solution

Clostridium difficile

Hygiene management for care utensils

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The comprehensive white paper on the problem of spores and hygiene measures to combat it

Clostridium difficile (meanwhile on recommendation of the Robert-Koch-Institute Clostridioides difficile) is a highly contagious bug. It is particularly dangerous because it can spread so quickly. This white paper provides information about typical transmission routes and insights into effective hygiene management for cases of C. diff, focusing on effective cleaning using cleaning and disinfection machines as a significant factor in hygiene management.



  • C. difficile transmission
  • Pathogen profile
  • Prevention
  • User study
  • Bedpan processing

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The process of cleaning bedpans

When handling used care utensils, it is vital to follow the guidelines available for hand disinfection and personal protective equipment. The risk of contamination is present wherever the bedpan is handled, whether that is:

  • transport
  • emptying
  • storage

When these processes are carried out by hand, that risk is increased – hands can be contaminated by droplets (aerosol) and the environment risks contamination from splashes.

The benefits of integrated bedpan washing units

cleaning and disinfection machine TopLine by MEIKO
cleaning and disinfection machine integrated in patient's bath

Fully automatic emptying, cleaning and disinfection of care utensils in a cleaning and disinfection machine minimises the risk of contamination or re-contamination. A high standard of hygiene, as well as optimising occupational safety and user friendliness are inherent features of MEIKO cleaning and disinfection machines. They convince by features such as:

  • the door on the TopLine cleaning and disinfection machine can be fitted with an automatic infrared control system or a foot switch to open it preventing contamination via hands 
  • the cleaning and disinfection machine can be built into the wall in the patient's room or wet room minimising the danger of pathogen transmission by keeping transport distances short 
  • one-touch operation with large keys, clear symbols and information in plain text keeping potential for user error to a minimum

The magic combination of mechanics, heat and chemicals

C. difficile spores are renowned for their resistance to oxygen and heat. An Avalue of 60 (80 °C for a duration of 60 seconds) does not kill enough C. difficile spores on care utensils.* 

TopLine machines by Meiko:

  • use strong wash and steam jets for a thorough clean, highly effective in washing off germs
  • apply temperatures above 80 °C and an alkaline detergent in a recognised programme to remove C. difficile spores to an acceptable level
  • the disinfection parameters on TopLine cleaning and disinfection machines are set to an Avalue of 60
  • the A0value can be selected up to 3,000 in predefined increments for when an even higher standard of safety is required

The disinfection performance of Meiko cleaning and disinfection machines is validated according to EN ISO 15883-3 using temperature loggers to measure temperature-time intervals and, where appropriate, bioindicators (Enterococcus faecium) to provide microbiological evidence of cleaning/disinfection.

User study

In a 16-month user study, the weak points in the cleaning of care utensils were analysed. A frequent reason is the faulty operation of equipment by personnel due to a lack of user-friendliness. Find out more in the whitepaper Clostridioides difficile.

* Alfa, MJ et al.: Alkaline detergent combined with a routine ward bedpan washer disinfector cycle eradicates Clostridium difficile spores from the surface of plastic bedpans, in:American Journal of Infection Control, 2013, 41, pp. 381–383.