Hospital Outbreak of Pulmonary and Cutaneous Zygomycosis due to Contaminated Linen Items From Substandard Laundry

Abstract

Suboptimal conditions of washing, drying, and storage contributed to the massive linen contamination and the outbreak of zygomycosis.

Seasonal Outbreak of Bacillus Bacteremia Associated With Contaminated Linen in Hong Kong

“…Therefore, the overall increase in cases of Bacillus bacteremia during the outbreak period could represent either exogenous contamination from the contaminated linens at the time of obtaining the blood culture (pseudo-bacteremia), or genuine invasive infection in immunocompromised and critically ill patients who acquired the Bacillus species from the heavily contaminated linens during hospitalization. Second, we did not look for Bacillus species during our environmental surveillance of laundry because we had focused our resources on zygomycetes during the initial outbreak investigation [17]. Although it is possible that the Bacillus contamination of linen had also occurred in the substandard laundry, definitive association was not feasible.…”

“…Environmental surveillance of the designated laundry demonstrated heavy contamination by zygomycetes. The outbreak was terminated when an alternative laundry provider was secured for the hospital [17]. In response to this hospital outbreak of pulmonary and cutaneous zygomycosis due to contaminated linen items from a substandard laundry in the summer of 2015, a retrospective analysis of hospital blood culture isolates was performed and an increased number of patients with Bacillus species in blood cultures was observed during the R. microsporus outbreak period.…”

“…Data on patients with isolation of Bacillus species from blood culture were retrieved, including patient demographics, date of admission, date of blood culture request, presence of indwelling catheters, and the site of blood culture collection. Patient-level clinical data were reviewed by physicians via the clinical management system of the hospital as previously described [17][18][19][20][21][22]. In this study, Bacillus bacteremia was defined as any patient with a positive blood culture isolating Bacillus species, with no differentiation made between genuine bacteremia or pseudo-bacteremia.…”

Role of Hand Hygiene Ambassador and Implementation of Directly Observed Hand Hygiene Among Residents in Residential Care Homes for the Elderly in Hong Kong

“…Environmental samples were collected using Polywipe sponge swabs 5 cm × 10 cm in size (Medical Wire and Equipment, UK) as previously described. 17 These swabs were sterile, premoistened, thin flexible sponges tailormade for sampling environmental surfaces. Each sampled sponge swab was placed in an individual sterile plastic bag, which was sealed and clearly labeled before further processing in the laboratory.…”

Outbreak of invasive wound mucormycosis in a burn unit due to multiple strains of Mucor circinelloides f. circinelloides resolved by whole genome sequencing

“…Outbreaks of mucormycosis have been reported in the USA, UK and Europe (14). Since 2008, outbreaks or clustered cases have been reported after the tornadoes in Joplin, Missouri (13 patients) (15, 16), in the ICU in France (three patients) (17), in adults (six patients) (18) or infants (five patients) (19) exposed to contaminated linens in the US, in infants in Egypt (five patients) (20), and in patients undergoing arthroscopy in Argentina (40 patients) (21). More specifically, in a Belgian burn unit, Christiaens et al described an outbreak of Lichtheimia corymbifera associated with non-sterile elastoplast bandage contamination in seven burn patients including five with infection and two with colonization (22).…”