Linen can be a cause for mold, and can prove dangerous especially when it comes to hospital linen.
A report published in CNN cited mold outbreak in Pittsburgh hospitals way back in 2014 was due to the linen provider. These findings were shared in emails with CNN. This information is now being widely discussed across the world. Here is the whole story:
UPMC informed the Allegheny County Health Department, Pennsylvania Department of Health, and US Centers for Disease Control and Prevention that its independent testing led UPMC officials to believe the linens were the likely source of the outbreak, according to the emails.
Six deaths since October 2014 have been linked to heavy mold growth on linens at three UPMC hospitals – Presbyterian, Montefiore and Shadyside. The new emails reveal additional testing seeking to pinpoint the source of the outbreak.
Mold at two Pittsburgh hospitals linked to 5 deaths
Environmental samples were taken on February 21, 22 and April 21, 2016, at UPMC Presbyterian and Montefiore hospitals and at the laundry facilities.
A whole genome sequencing report by an independent laboratory based on these specimens “[suggests] that fungi from the linen provider have been brought into the [Presbyterian University Hospital] laundry,” according to the report provided in the email.
Mucor is a species of mucormycosis, which are fungal spores commonly found outdoors. However, they can cause a rare and sometimes fatal
fungal infection in patients who are immunocompromised.
Hospital linen is required to be “hygienically clean,” according to the Healthcare Laundry Accreditation Council. That means linens are not sterile, but in a clean state, free of pathogens in sufficient numbers to minimize risk of infection, and the clean textiles are not inadvertently contaminated before use.
A whole genome sequencing report compares environmental samples from which the DNA has been extracted and sequenced to show the fingerprint of the sample at a high resolution, according to Dr. Barun Mathema, an assistant professor of epidemiology at Columbia’s Mailman School of Public Health.
“Nobody is 100% sure, if you read carefully, there will always be a bit of a wiggle room caveat,” said Mathema. In general, it is rare that epidemiological testing comes to an absolutely conclusive result because of variables that come into play when epidemiologists attempt to replicate the exact environment in which the case occurred.
An earlier testing conducted on February 1, 2016, by hospital environmental specialists also found a heavy build-up of lint and mold near the Paris Co. linen facility vent through which unfiltered air dried the linens.
When the linen from Paris Co. was tested, a cart of wet sheets delivered to the Montefiore laundry storage area bore “heavy fungal growth of Mucor and rhizopus,” according to their report, which was not made public until early 2017.
“There is no evidence to indicate an ongoing outbreak at this time; however, the state health department is in the process of reviewing additional information as part of the ongoing investigation.”
The UPMC hospital system mold outbreak began in October 2014. By September 2015, four patients had died of fungal infections at UPMC Presbyterian and Montefiore hospitals. By that time, the transplant ICU at Presbyterian had temporarily closed.
In September 2015, while the Presbyterian transplant ICU was closed, the CDC investigated possible sources of the mold outbreak. The results of the investigation were published in the May 2016 Morbidity and Mortality Weekly Report. Investigators said that the fatal infections were not attributed to the mold-covered linens, but rather to ventilation that may have allowed dust and mold spores to enter the hospital rooms.
In May 2016, Pennsylvania Governor Tom Wolf again requested the CDC consult with the state health department and UPMC because a fifth fungal infection recipient had been identified in the Presbyterian ICU.
That additional patient was Daniel Krieg, a kidney transplant patient who died in July 2016. UPMC medical reports show Krieg had fungal pneumonia and that fungal-infected sections of his left lung were removed.
Hospital linens are required to be “hygienically clean,” according to the Healthcare Laundry Accreditation Council. That means linens are not sterile, but in a clean state, free of pathogens in sufficient numbers to minimize risk of infection, and the clean textiles are not inadvertently contaminated before use.
The Textile Rental Services Association of America Inc. issues “hygienically clean” certifications to healthcare laundries that seek it. The certification requires quarterly ongoing microbial testing and a supplemental second inspection during a facility’s three-year certification period, according to TRSA President and CEO Joseph Ricci. “Many hospital laundries have received the Hygienically Clean Healthcare certification, which is recognized as the highest standard of certification in healthcare linen safety and cleanliness, and is the only healthcare standard in North America that requires initial and ongoing quarterly microbiological testing based on internationally recognized protocols and standards,” Ricci said.
“Hygienically Clean Healthcare tests for molds and yeasts, and after more than 3,000 microbial tests of healthcare linens and garments, there has never been any evidence of Rhizopus or other dangerous molds,” Ricci said, referring to the association’s testing from many facilities.