In New Orleans Children’s Hospital there was identified an outbreak of a flesh-eating fungal infection, mucormycosis, and several children died between August 2008 and July 2009. This infection is most likely spread by bed linens, towels or gowns, according to a medical journal.
An estimated 75,000 patients with infections picked up in health care facilities die in hospitals each year, according to figures released last month by the C.D.C.
The outbreak may have spread unchecked, at least in part, because of lapses in the hospital’s infection controls and sloppy handling of contaminated linens, according to a review of emails, patient records, legal testimony from hospital and laundry staff, and interviews with doctors, lawyers, federal health officials, hospital administrators and patients’ families. Workers unloaded clean linens on the same dock where medical waste was removed, moved clean and soiled linens on the same carts, and stored linens in hospital hallways covered in dust from a nearby construction site, court records indicated.
Hospital officials first suspected they had a problem in late June 2009, and in the weeks after alerted state and federal health officials, but few others. They contacted the children’s families only after the journal article“Mucormycosis Outbreak Associated With Hospital Linens” appeared in The Pediatric Infectious Disease Journal. (The article did not identify the hospital, but a local television station, WVUE, disclosed it based on a tip from a local doctor, Brobson Lutz.)
“We failed to do what we should have done, pure and simple,” Dr. John F. Heaton, the hospital’s associate medical director, said during a news conference this April, in which he acknowledged that the infections most likely contributed to the children’s deaths.
In the rare instances when linens have been associated with transmitting illnesses, the problem is usually caused by improper transportation or storage, said Lisa Waldowski, an infection control specialist with the Joint Commission, the organization that accredits most American hospitals. Hospitals typically do not sterilize linens, except those used in operating rooms. Hospital bedsheets and towels typically are washed and bleached to reach the same standard of cleanliness as hotel laundry. One key difference is that medical linens are supposed to be wrapped in bags or cellophane for transport.
In response to several unrelated outbreaks in recent years, the C.D.C. started an initiative to help hospitals and health departments communicate with the public about medical errors and infections acquired in health care facilities. Abbigail Tumpey, who leads the effort, said that while it is important to avoid scaring away patients, hospitals that are open about problems and the steps taken to remedy them have built public trust.