How Clean Is the Linen at My Hospital? The Mucorales on Unclean Linen Discovery Study of Large United States Transplant and Cancer Centers

Sundermann, Alexander; Clancy, Cornelius J.; Pasculle, A. William; Liu, Guojun; Cumbie, R; Driscoll, Eileen; Ayres, Ashley; Donahue, Lisa; Pergam, Steven A.; Abbo, Lilian; Andes, David R.; Chandrasekar, Pranatharthi H.; Galdys, Alison; Hanson, Kimberly E.; Marr, Kieren A.; Mayer, Jeanmarie; Mehta, Seema; Morris, Michele; Perfect, John R.; Revankar, Sanjay G.; Smith, Becky; Swaminathan, Sankar; Thompson, George R.; Varghese, Merin; Vázquez, José Antonio; Wingard, John R.; Nguyen, M.H.

doi:10.1093/cid/ciy669

Cited by 30 publications

(19 citation statements)

References 12 publications

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“…Some other cases occurred in cluster and were linked to the use of contaminated devices (such as adhesive bandages, wooden tongue depressors, ostomy bags) or environmental reservoir (water circuitry and adjacent building construction) [31]. Recent outbreaks have been linked to contaminated hospital linens [34,35,36]. Skin was the most common localization (57%), followed by gastrointestinal tract (15%) in HCM [31].…”

Section: Health-care Associated Mucormycosis (Hcm)mentioning

confidence: 99%

Disease Entities in Mucormycosis

Serris

Danion

Lanternier

2019

JoF

113

110

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Mucormycosis is an emerging life-threatening fungal infection caused by Mucorales. This infection occurs mainly in immunocompromised patients, especially with hematological malignancy, transplantation, or diabetes mellitus. Rhino-orbito-cerebral and pulmonary mucormycosis are the predominant forms. Interestingly, location is associated with the underlying disease as pulmonary mucormycosis is more frequent in hematological malignancy patients whereas rhino-orbito-cerebral mucormycosis is associated with diabetes. Cutaneous mucormycosis results from direct inoculation, mainly after trauma or surgery. Gastro-intestinal mucormycosis occurs after ingestion of contaminated food or with contaminated device and involves the stomach or colon. Disseminated disease is the most severe form and is associated with profound immunosuppression. Uncommon presentations with endocarditis, osteoarticluar or isolated cerebral infections are also described. Finally, health-care associated mucormycosis is a matter of concern in premature newborns and burn units. Clinical symptoms and CT scan findings are not specific, only the early reversed halo sign is associated with pulmonary mucormycosis. Circulating Mucorales DNA detection is a recent promising diagnostic tool that may lead to improving the diagnosis and prompting therapeutic initiation that should include antifungal treatment, correction of the underlying disease and surgery when feasible.

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Section: Health-care Associated Mucormycosis (Hcm)mentioning

confidence: 99%

Disease Entities in Mucormycosis

Serris

Danion

Lanternier

2019

JoF

113

110

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“…Recently, a number of outbreaks were linked to contaminated hospital linens or laundry carts and bins [35][36][37][38]. The full extent to which contaminated linens contribute to the burden of hospital-acquired mucormycosis is unknown and may be under-appreciated.…”

Section: Hospital Environmentsmentioning

confidence: 99%

“…Moreover, it is unknown whether contaminated linens account for sporadic cases of mucormycosis. Sundermann and colleagues performed fungal cultures on freshly laundered linens at 15 transplant and cancer hospitals [38]. At 33% of hospitals the lines were visibly unclean.…”

Section: Hospital Environmentsmentioning

confidence: 99%

Biotic Environments Supporting the Persistence of Clinically Relevant Mucormycetes

Rautemaa‐Richardson

2019

JoF

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Clinically relevant members of the Mucorales group can grow and are found in diverse ecological spaces such as soil, dust, water, decomposing vegetation, on and in food, and in hospital environments but are poorly represented in mycobiome studies of outdoor and indoor air. Occasionally, Mucorales are found in water-damaged buildings. This mini review examines a number of specialised biotic environments, including those revealed by natural disasters and theatres of war, that support the growth and persistence of these fungi. However, we are no further forward in understanding exposure pathways or the chronicity of exposure that results in the spectrum of clinical presentations of mucormycosis.

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“…In response to a mucormycosis outbreak where linens were one suspected source, investigators conducted an audit of 15 transplant and cancer hospitals and found seven (47%) centers had freshly laundered healthcare linens contaminated with mucormycetes. Three (20%) of the 15 centers failed to meet hygienically clean standards for mucormycetes [95]. In total, 14% of healthcare linens were found to have mucormycetes.…”

Section: Components Of An Outbreak Investigationmentioning

confidence: 99%

A Guide to Investigating Suspected Outbreaks of Mucormycosis in Healthcare

Hartnett

Jackson

Perkins

et al. 2019

JoF

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This report serves as a guide for investigating mucormycosis infections in healthcare. We describe lessons learned from previous outbreaks and offer methods and tools that can aid in these investigations. We also offer suggestions for conducting environmental assessments, implementing infection control measures, and initiating surveillance to ensure that interventions were effective. While not all investigations of mucormycosis infections will identify a single source, all can potentially lead to improvements in infection control.

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How Clean Is the Linen at My Hospital? The Mucorales on Unclean Linen Discovery Study of Large United States Transplant and Cancer Centers

Cited by 30 publications

References 12 publications

Disease Entities in Mucormycosis

Disease Entities in Mucormycosis

Biotic Environments Supporting the Persistence of Clinically Relevant Mucormycetes

A Guide to Investigating Suspected Outbreaks of Mucormycosis in Healthcare

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