Summertime Bacillus cereus colonization of hospital newborns traced to contaminated, laundered linen.

Hosein, IK.

Summertime Bacillus cereus colonization of hospital newborns traced to contaminated, laundered linen. - 2013

NMUH Staff Publications 85

<h4>BACKGROUND: </h4><p>Routine screening of premature newborns for haemolytic streptococci, Staphylococcus aureus and enteric Gram-negative bacteria done at birth using umbilical swabs identified clustering of babies colonized with Bacillus cereus in summers of 2009 and 2010 at a 400-bedded UK general hospital.</p><h4>AIM: </h4><p>To determine the source of this organism by focusing on the clinical environment.</p><h4>METHODS: </h4><p>Umbilical swab screening was extended to all newborns and the labour ward environment, including construction-related dust, was sampled for B.&nbsp;cereus.</p><h4>FINDINGS: </h4><p>During the summer of 2009, 65% of newborns had umbilical swabs which were culture positive for B.&nbsp;cereus. Blood agar and B.&nbsp;cereus selective agar impression plates of unused labour ward linen, and freshly received linen from the hospital's external laundry, gave mainly confluent growth of B.&nbsp;cereus in &gt;85% of items sampled. In-use and exposed healthcare products including liquid handwashing agents, paper hand-towels, vaginal lubricants, labour ward dust and air were culture negative. Linen contamination and umbilical swab culture positivity both approached zero in autumn. B.&nbsp;cereus colonization of newborn umbilici recurred in summer 2010 and unused laundered linen was again found to be as contaminated. Washing linen at the laundry in a washer-extractor, with higher dilution than the continuous tunnel washer normally used, coincided with lowering of detectable B.&nbsp;cereus numbers in unused washed linen and no clustering in newborns the following summer (2011).</p><h4>CONCLUSION: </h4><p>Freshly laundered linen can be contaminated with B.&nbsp;cereus with subsequent spread and colonization of newborns. This contamination appears to be associated with low-dilution washing and high ambient temperatures.</p>

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