During 2012, our hospital was faced with a vancomycin-resistant Enterococcus faecium (VRE) outbreak. Washer-disinfectors are used for the cleaning and thermal disinfection of bedpans. The European guideline NEN-ISO 15883-3 (ISO) states that washer- disinfectors have to achieve a minimum A0 value of 60 for appropriate disinfection of bedpans (≈ 80 °C for 60 seconds or 90 °C for 6 seconds). However, previous data have shown that some E. faecium strains survive 60 seconds at 80 °C. Following ISO, the A0 measurement should include a cold (a minimum interval of 60 minutes since the machine was last used) and hot start.