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A blog from industry experts devoted to public health awareness, best practices, and the role of environmental cleaning and disinfection, to promote safer, healthier public spaces.

Soak and spread? How hospital bucket microbial contamination persists December 6, 2023
CloroxPro CA

Soak and spread? How hospital bucket microbial contamination persists 

While the use of dilution control systems is common in healthcare facilities, they carry the potential for serious risks that ready-to-use wipes can help you avoid, as explored in a previous post. Along with quality control concerns relating to the system, chemical concentrations, and water used, another consideration when weighing your approach to sanitization and disinfection are the dangers associated with hospital buckets themselves. In fact, through cross-contamination, the very vessels that hold the disinfectant can lead to outbreaks. Due to human error, personnel who may not be following standard operating procedures (SOP) can also contribute to the risk. In this way, single-use, ready-to-use wipes offer a significant advantage by eliminating this risk entirely.

The study findings outlined below are important to consider for anyone tasked with protecting staff, patients and visitors from hospital-acquired infections.

  • In a study of 10 hospitals, swab samples were collected from the inside surfaces of buckets in which towels were soaked in disinfectant. Samples were cultured for total bacteria (heterotrophic bacteria), coliform bacteria, E coli, C difficile, MRSA, molds, and aerobic spore-forming bacteria. Viable bacteria were detected on 67% of the soak buckets, spore-forming bacteria were isolated from 44%, and coliform bacteria from 12%.1
  • A 2022 study identified heavy growth of Serratia marcescens and Achromobacter xylosoxidans on high-touch hospital surfaces, that were not present before disinfection. A housekeeper’s bucket of quaternary ammonium-based disinfectant was found to contain 9.3×104 CFUs/ml of these microbes, the same strains of which were recovered from surfaces in patient rooms. The housekeeper, who seldom cleaned patient rooms, was not emptying and drying the bucket between uses, and had used the contaminated disinfectant in different areas for months (“double-dipping”). 2,3
  • A double-crossover study in a 1,000-bed teaching hospital measured the comparative effectiveness of either pre-moistened wipes or cloth soaked in a bucket containing 1,000 ppm chlorine for disinfection. Environmental samples from surfaces in 2 surgical and cardiovascular wards were analyzed over 29 weeks. Pre-moistened wipes were found to significantly decrease microbial bioburden from high-touch surfaces. 4

If your facility currently uses dilution control systems and buckets, these studies underscore the need to ask yourself:

  • Am I familiar with my facility’s SOP for cleaning containers, and for amount of disinfectant needed within to achieve disinfecting claims?
  • Is the SOP being followed, and who is responsible for auditing and monitoring?
  • How consistent and thorough is our Environmental Services training process?

Not only do single-use, ready-to-use wipes offer greater ease of use, time-savings, and a streamlined sanitization and disinfection process, but they allow you to avoid contaminating the disinfectant and the risk of cross-contamination that comes with the cloth-and-bucket method. It all adds up to a safer environment for staff, patients, and visitors.

  • Alcohol-free, non-bleach and non-corrosive
  • Less residue, easy on surfaces, multi-surface cleaner disinfectant
  • Kills 56 pathogens in 1 minute or less, including 13 antibiotic-resistant ones, including TB in 1 minute and kills C. auris in 3 minutes
  • Ideal for daily use in high-turnover areas on hard surfaces
  • Alcohol-free quat formula 
  • 50 pathogens killed in 2 minutes or less (bacteria, viruses and fungi]
  • Low odour, low residue, non-bleach
  • Can be used daily on portable and mobile healthcare facility equipment 
  • Built to kill nearly 60 microorganisms in ≤3 minutes 
  • Improved surface compatibility and residue profile
  • Kills C. difficile spores in 3 minutes 
  1. Sifuentes LY, Gerba CP, Weart I, Engelbrecht K, Koenig DW. Microbial contamination of hospital reusable cleaning towels. Am J Infect Control. 2013;41(10):912-915.
  2. Boyce, J.M. Modern technologies for improving cleaning and disinfection of environmental surfaces in hospitals. Antimicrob Resist Infect Control 5, 10 (2016).
  3. Boyce, J. M., Havill, N. L. In-use contamination of a hospital-grade disinfectant. Am J Infect Control. 2022; 50(12):1296-1301.
  4. Siani H, Wesgate R, Maillard JY. Impact of antimicrobial wipes compared with hypochlorite solution on environmental surface contamination in a health care setting: A double-crossover study. Am J Infect Control. 2018;46(10):1180-1187.