{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:42:59Z","timestamp":1790116979377,"version":"4.0.1"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T00:00:00Z","timestamp":1626739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In an investigation of hospital-acquired mucormycosis cases among transplant recipients, healthcare linens (HCLs) delivered to our center were found to be contaminated with Mucorales. We describe an investigation and remediation of Mucorales contamination at the laundry supplying our center.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed monthly RODAC cultures of HCLs upon hospital arrival, and conducted site inspections and surveillance cultures at the laundry facility. Remediation was designed and implemented by infection prevention and facility leadership teams.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Prior to remediation, 20% of HCLs were culture-positive for Mucorales upon hospital arrival. Laundry facility layout and processes were consistent with industry standards. Significant step-ups in Mucorales and mold culture-positivity of HCLs were detected at the post-dryer step (0% to 12% [P = .04] and 5% to 29% [P = .01], respectively). Further increases to 17% and 40% culture-positivity, respectively, were noted during pre-transport holding. Site inspection revealed heavy Mucorales-positive lint accumulation in rooftop air intake and exhaust vents that cooled driers; intake and exhaust vents that were facing each other; rooftop and plant-wide lint accumulation, including in the pre-transport clean room; uncovered carts with freshly-laundered HCLs. Following environmental remediation, quality assurance measures and education directed toward these sources, Mucorales culture-positivity of newly-delivered HCLs was reduced to 0.3% (P = .0001); area of lint-contaminated rooftop decreased from 918 m2 to 0 m2 on satellite images.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Targeted laundry facility interventions guided by site inspections and step-wise culturing significantly reduced Mucorales-contaminated HCLs delivered to our hospital. Collaboration between infection prevention and laundry facility teams was crucial to successful remediation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciab638","type":"journal-article","created":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T19:11:58Z","timestamp":1626721918000},"page":"1401-1407","source":"Crossref","is-referenced-by-count":10,"title":["Remediation of Mucorales-contaminated Healthcare Linens at a Laundry Facility Following an Investigation of a Case Cluster of Hospital-acquired Mucormycosis"],"prefix":"10.1093","volume":"74","author":[{"given":"Alexander J","family":"Sundermann","sequence":"first","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"},{"name":"University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelius J","family":"Clancy","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"},{"name":"University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A William","family":"Pasculle","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guojun","family":"Liu","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoji","family":"Cheng","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard B","family":"Cumbie","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen","family":"Driscoll","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Ayres","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Donahue","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Buck","sequence":"additional","affiliation":[{"name":"University of Minnesota Department of Environmental Health and Safety, Duluth, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Streifel","sequence":"additional","affiliation":[{"name":"University of Minnesota Department of Environmental Health and Safety, Duluth, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlene A","family":"Muto","sequence":"additional","affiliation":[{"name":"University of Virginia Division of Infectious Diseases and International Health, Charlottesville, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Hong","family":"Nguyen","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"},{"name":"University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,7,20]]},"reference":[{"key":"2022042816592440800_CIT0001","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1086\/432579","article-title":"Epidemiology and outcome of zygomycosis: a review of 929 reported cases","volume":"41","author":"Roden","year":"2005","journal-title":"Clin Infect Dis"},{"key":"2022042816592440800_CIT0002","doi-asserted-by":"crossref","first-page":"ofw268","DOI":"10.1093\/ofid\/ofw268","article-title":"Trends in hospitalizations related to invasive aspergillosis and mucormycosis in the United States, 2000\u20132013","volume":"4","author":"Vallabhaneni","year":"2017","journal-title":"Open Forum Infect Dis"},{"key":"2022042816592440800_CIT0003","first-page":"765","article-title":"Outbreaks of Mucorales and the species 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The Mucorales on unclean linen discovery study of large United States transplant and cancer centers","volume":"68","author":"Sundermann","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2022042816592440800_CIT0009","year":"2019"},{"key":"2022042816592440800_CIT0010"},{"key":"2022042816592440800_CIT0011"},{"key":"2022042816592440800_CIT0012","doi-asserted-by":"crossref","DOI":"10.1099\/mgen.0.000473","article-title":"Genetic diversity of clinical and environmental Mucorales isolates obtained from an investigation of mucormycosis cases among solid organ transplant recipients","author":"Nguyen","year":"2020","journal-title":"Microb Genom"},{"key":"2022042816592440800_CIT0013","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1017\/ice.2015.135","article-title":"Healthcare laundry and textiles in the United States: review and commentary on contemporary infection prevention issues","volume":"36","author":"Sehulster","year":"2015","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2022042816592440800_CIT0014","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1128\/MMBR.66.3.506-577.2002","article-title":"Microbial cellulose utilization: fundamentals and biotechnology","volume":"66","author":"Lynd","year":"2002","journal-title":"Microbiol Mol Biol Rev"},{"key":"2022042816592440800_CIT0015","doi-asserted-by":"crossref","first-page":"11864","DOI":"10.1038\/s41598-019-48296-w","article-title":"Carbon assimilation profiles of mucoralean fungi show their metabolic versatility","volume":"9","author":"Paw\u0142owska","year":"2019","journal-title":"Sci Rep"},{"key":"2022042816592440800_CIT0016","doi-asserted-by":"crossref","DOI":"10.1093\/cid\/ciaa652","article-title":"Isavuconazole is as effective as and better tolerated than voriconazole for antifungal prophylaxis in lung transplant recipients","author":"Samanta","year":"2021","journal-title":"Clin Infect Dis"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciab638\/39969384\/ciab638.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/74\/8\/1401\/43493302\/ciab638.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/74\/8\/1401\/43493302\/ciab638.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,28]],"date-time":"2022-04-28T18:32:07Z","timestamp":1651170727000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/74\/8\/1401\/6324310"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,20]]},"references-count":16,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,7,20]]},"published-print":{"date-parts":[[2022,4,28]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciab638","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,4,15]]},"published":{"date-parts":[[2021,7,20]]}}}