Table 2 Environmental surveillance results of outbreaks with confirmed E. anophelis

1

Hospital water from central tank and wards, dialysis water, dialysis fluid, seven bottles of disinfectant, oxygen masks, distributed oxygen gases, community tap water and a rainwater cistern

Columbia agar

none

-

Unknown

Unknown

2

50 cultures from 25 potential surfaces and equipment including incubators, monitors, sinks, faucets, aerators and water from faucets.

n/a

Faucet aerator in material washing waste basin (n = 1)

Yes

Faucet aerator

Water

5

27 cultures from 9 water points: sinks, aerator swabs and water samples.

n/a

2 water samples, 4 aerators, 3 sinks (n = 9)

Typing not performed

Water taps

Health care worker’s hands

6

281 swab cultures of equipment and surfaces within patient rooms, restrooms, nursing stations, electronics, furniture, patient care devices, patient transport carts, sinks, and water taps.

BA and MAC, 24 h

4 water taps in ICU, 2 washbasins in ICU, 1 suction regulator in hospital ward (n = 7)

Yes, all 7 environmental isolates in Cluster 1

Cluster 1: water taps

Other clusters: unknown

Water

8

41 cultures of healthcare and personal care products, 29 samples of tap water 61 water-associated biofilm samples (n = 131)

n/a

1 sample of standing water with contaminated patient material

Typing not performed

Unknown

Unknown

9

34 tap water samples and 117 surface swabs (beds, monitors, remote controllers, light switches feedings tubes/bags swabs and sputum suction regulator swabs)

Tryptic soy broth, 48 h followed by BA and MAC 18-24 h CO₂

18 tap water samples and 4 surface swabs (2 feedings tubes/bags and 2 sputum suction regulators) (n = 22)

Yes, 4/4 surface swabs and 5/14 water samples were related (PFGE).

Typing not performed on remaining 4 water samples.

Water taps

Feeding tube/bag and sputum suction devices

10

n/a

5% horse agar

3 sinks, 2 sink drains and one handrail (n = 6)

Yes, 2 sink swab related to outbreak isolates. Other 4 isolates not related.

Sink

Unknown

11

15 swabs of equipment or re-usable items, 79 aerator swabs, swabs of internal surfaces of 5 water taps, 10 samples of dialysis water in patient rooms, 8 samples from dialysis taps in dialysis centres, 6 aerators in OR scrub rooms, unknown number of water samples of central water supply.

BA, 48 h

35 aerator swabs, 5 swabs of internal surface of water taps.†

14/14 aerator swabs were > 99% similar to clinical isolates (Rep-PCR)

2/4 aerator swabs < 180 SNP difference (WGS)

Water taps

Water