{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T07:16:45Z","timestamp":1773818205163,"version":"3.50.1"},"reference-count":32,"publisher":"Cambridge University Press (CUP)","issue":"8","license":[{"start":{"date-parts":[[2022,11,8]],"date-time":"2022-11-08T00:00:00Z","timestamp":1667865600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X22002550_as1\"><jats:title>Objective:<\/jats:title><jats:p>To investigate the source in an outbreak of carbapenem-resistant <jats:italic>Acinetobacter baumannii<\/jats:italic> (CRA) in a general hospital due to contamination of a laundry evaporative cooler and the laundry environment using multilocus sequence typing (MLST).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22002550_as2\"><jats:title>Methods:<\/jats:title><jats:p>For CRA culture, clinical samples were collected from infected patients and close contacts, and environmental sampling was performed in patient surroundings and laundry facilities. MLST was used for the molecular typing of representative CRA isolates. Bacterial isolates with identical sequence types were considered epidemiologically linked and attributable to the same source. OXA genes in Acinetobacter baumannii were detected using polymerase chain reaction (PCR).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22002550_as3\"><jats:title>Results:<\/jats:title><jats:p>In total, 58 patients were affected in this outbreak. The mean patient age was 75.3, and 50% were female. The most common diagnoses at admission were skin and soft-tissue infection (n = 12, 20.7%) and pneumonia (n = 12, 20.7%). OXA-23 was positive in 64.7% of isolates. A CRA isolate from the evaporative cooler in the laundry was identical to that of 11 patients across 3 wards, belonging to ST345. Isolates from 3 laundry linen racks were identical to those of 7 patients from 3 wards, classified as ST1145. Isolates found on another linen rack and a pajama shelf were identical to isolates from 3 other patients from 2 wards, belonging to ST2207. There was no significant difference between sequence type distributions of clinical and environmental isolates (P = .12), indicating high likelihood of CRA originating from the same source.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22002550_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>MLST confirmed that contamination of the laundry evaporative cooler and surrounding environment caused a polyclonal CRA hospital outbreak. Hospital laundry is an important area for infection control and outbreak investigations of CRA.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2022.255","type":"journal-article","created":{"date-parts":[[2022,11,8]],"date-time":"2022-11-08T09:20:57Z","timestamp":1667899257000},"page":"1274-1280","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["Clean clothes or dirty clothes? Outbreak investigation of carbapenem-resistant <i>Acinetobacter baumannii<\/i> related to laundry contamination through multilocus sequence typing (MLST)"],"prefix":"10.1017","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2161-1420","authenticated-orcid":false,"given":"Alfred Lok Hang","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eddie Chi Ming","family":"Leung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben Wai Hong","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leo Chun Hei","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoyo Lok Yiu","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosana Ka Yin","family":"Hung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sindy Sin Yee","family":"Ho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viola Chi Ying","family":"Chow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2022,11,8]]},"reference":[{"key":"S0899823X22002550_ref2","doi-asserted-by":"publisher","DOI":"10.3904\/kjim.2015.178"},{"key":"S0899823X22002550_ref12","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1089\/mdr.2018.0433","article-title":"Emergence of carbapenem-resistant Acinetobacter baumannii ST195 harboring blaOXA-23 isolated from bacteremia in Hong Kong","volume":"25","author":"Leung","year":"2019","journal-title":"Microb Drug Resist"},{"key":"S0899823X22002550_ref14","unstructured":"14. M100: performance standards for antimicrobial susceptibility testing, 29th edition. Clinical Laboratory Standards Institute website. https:\/\/clsi.org\/standards\/products\/microbiology\/documents\/m100\/. Published 2019. Accessed October 17, 2022."},{"key":"S0899823X22002550_ref25","doi-asserted-by":"publisher","DOI":"10.11150\/kansenshogakuzasshi.90.480"},{"key":"S0899823X22002550_ref26","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ1006"},{"key":"S0899823X22002550_ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmm.2019.151339"},{"key":"S0899823X22002550_ref4","doi-asserted-by":"crossref","first-page":"103675","DOI":"10.1016\/j.fm.2020.103675","article-title":"Acinetobacter spp in food and drinking water\u2014a review","volume":"95","author":"Carvalheira","year":"2021","journal-title":"Food Microbiol"},{"key":"S0899823X22002550_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2015.07.010"},{"key":"S0899823X22002550_ref17","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.43.9.4382-4390.2005"},{"key":"S0899823X22002550_ref9","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.jhin.2015.08.007","article-title":"Prevention and control of multidrug-resistant gram-negative bacteria: recommendations from a Joint Working Party","volume":"1","author":"Wilson","year":"2016","journal-title":"J Hosp Infect"},{"key":"S0899823X22002550_ref13","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01021-06"},{"key":"S0899823X22002550_ref5","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph110201844"},{"key":"S0899823X22002550_ref6","doi-asserted-by":"publisher","DOI":"10.1053\/jhin.2002.1300"},{"key":"S0899823X22002550_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2013.06.001"},{"key":"S0899823X22002550_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2009.10.014"},{"key":"S0899823X22002550_ref31","unstructured":"31. (HTM 01-04) Decontamination of linen for health and social care. NHS England website. https:\/\/www.england.nhs.uk\/publication\/decontamination-of-linen-for-health-and-social-care-htm-01-04\/. Published 2016. Accessed October 17, 2022."},{"key":"S0899823X22002550_ref1","doi-asserted-by":"publisher","DOI":"10.5001\/omj.2019.37"},{"key":"S0899823X22002550_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2006.01.004"},{"key":"S0899823X22002550_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2021.07.017"},{"key":"S0899823X22002550_ref29","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/0195-6701(95)90328-3","article-title":"an unexpected source of Acinetobacter","volume":"29","author":"Weernink","year":"1995","journal-title":"J Hosp Infect"},{"key":"S0899823X22002550_ref27","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy669"},{"key":"S0899823X22002550_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2017.07.010"},{"key":"S0899823X22002550_ref30","unstructured":"30. CCIDER Infection Prevention and Control Guidelines for Healthcare Linen. Hong Kong Center for Health Protection website. https:\/\/www.chp.gov.hk\/files\/pdf\/guide_to_infection_control_in_clinic_setting.pdf. Page 38. Published 2016. Accessed October 17, 2022."},{"key":"S0899823X22002550_ref10","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.jhin.2021.08.005","article-title":"Air dispersal of multidrug-resistant Acinetobacter baumannii: implications for nosocomial transmission during the COVID-19 pandemic","volume":"116","author":"Wong","year":"2021","journal-title":"J Hosp Infect"},{"key":"S0899823X22002550_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2009.07.012"},{"key":"S0899823X22002550_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijheh.2019.113425"},{"key":"S0899823X22002550_ref23","doi-asserted-by":"crossref","first-page":"S91","DOI":"10.1093\/cid\/cix044","article-title":"Seasonal outbreak of Bacillus bacteremia associated with contaminated linen in Hong Kong","volume":"2","author":"Cheng","year":"2017","journal-title":"Clin Infect Dis"},{"key":"S0899823X22002550_ref22","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1017\/S0950268800051724","article-title":"Contamination of hospital linen by Bacillus cereus","volume":"113","author":"Barrie","year":"1994","journal-title":"Epidemiol Infect"},{"key":"S0899823X22002550_ref28","doi-asserted-by":"publisher","DOI":"10.1053\/jhin.2001.1127"},{"key":"S0899823X22002550_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/S0934-8840(11)80326-9"},{"key":"S0899823X22002550_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2015.06.016"},{"key":"S0899823X22002550_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2010.12.016"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X22002550","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T08:31:17Z","timestamp":1692952277000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X22002550\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,8]]},"references-count":32,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["S0899823X22002550"],"URL":"https:\/\/doi.org\/10.1017\/ice.2022.255","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,8]]},"assertion":[{"value":"\u00a9 The Author(s), 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}