title: Possible involvement of reusable towels in the high rate of Bacillus species-positive blood cultures in Japanese hospitals.
abstract: BACKGROUND
  A number of outbreaks caused by Bacillus species have been reported to date. Outbreaks reported in the last decade have predominantly arisen in Japanese hospitals.
  
  
  OBJECTIVE
  To elucidate factors contributing to these real or pseudo outbreaks by Bacillus species, and to evaluate the rate of Bacillus species-positive blood culture samples in Japan.
  
  
  METHODS
  A systematic review of the literature was performed. Reports including data on outbreaks caused by Bacillus species were searched for in PubMed, Google Scholar and Evidence-based Medicine BMJ from inception through 10 Aug 2014. Japanese nationwide data on bacteriological tests were collected from Japan Nosocomial Infections Surveillance. Regional bacteriological data for Akita prefecture were collected using the Akita Regional Network for Infection Monitoring/Control System.
  
  
  RESULTS
  Contamination of reusable towels was suspected as a cause for the high rate of Bacillus-positive blood cultures in Japan. The rate of Bacillus species in blood cultures was much higher in Japan than in reports from other countries.
  
  
  CONCLUSIONS
  The high contamination rate of blood culture samples by Bacillus species in Japan is a matter of concern for infection control and medical treatment. Bacteriological investigation of reusable towels should be considered in hospitals with a high frequency of Bacillus-positive blood cultures.
authors.affiliation: Department of Laboratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Clinical Laboratory, Hirosaki University Hospital, Hirosaki, Japan.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Saito
authors.affiliation: Clinical Laboratory, Hirosaki University Hospital, Hirosaki, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Kondo
authors.affiliation: Hirosaki University Faculty of Medicine, Hirosaki, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Haruki
authors.affiliation: Department of Laboratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Clinical Laboratory, Hirosaki University Hospital, Hirosaki, Japan.
authors.forename: Masamichi
authors.initials: M
authors.lastname: Itoga
authors.affiliation: Department of Laboratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Clinical Laboratory, Hirosaki University Hospital, Hirosaki, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Yamamoto
authors.affiliation: Clinical Laboratory, Hirosaki University Hospital, Hirosaki, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kimura
authors.affiliation: Clinical Laboratory, Hirosaki University Hospital, Hirosaki, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Inoue
authors.affiliation: Clinical Laboratory, Hirosaki University Hospital, Hirosaki, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Clinical Laboratory, Hirosaki University Hospital, Hirosaki, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Tsutaya
authors.affiliation: Clinical Laboratory, Hirosaki University Hospital, Hirosaki, Japan.
authors.forename: Keiya
authors.initials: K
authors.lastname: Kojima
authors.affiliation: Department of General Internal Medicine and Clinical Laboratory Medicine, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Shigeharu
authors.initials: S
authors.lastname: Ueki
authors.affiliation: Department of General Internal Medicine and Clinical Laboratory Medicine, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Hirokawa
authors.affiliation: Department of Laboratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Clinical Laboratory, Hirosaki University Hospital, Hirosaki, Japan. Electronic address: kayaba@cc.hirosaki-u.ac.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kayaba
mesh_terms: D016863:Bacillaceae Infections / Q000209:etiology*; D001407:Bacillus / Q000302:isolation & purification*; D003428:Cross Infection / Q000209:etiology / Q000382:microbiology*; D004196:Disease Outbreaks; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000379:methods; D007564:Japan
keywords: Bacillus; Blood culture; Contamination; Outbreaks; Towels