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Table 1 Selected papers describing the transmission of multidrug-resistant Gram-negative organisms from the environment to the patient

From: The role of hospital environment in transmissions of multidrug-resistant gram-negative organisms

Sites Organisms Molecular methods Number of Samples Time Setting Ref
Aqueous environment
 Sinks and ultra-filtrate bags Multidrug-resistant Pseudomonas aeruginosa Repetitive element palindromic polymerase chain reaction (Rep-PCR) 21 unique patients
Environmental samples from 5 sinks
Jan 2012 – February 2014 Intensive care unit [18]
 Plumbing (Shower drains, sink taps, sink drain tailpieces, sink drain strainers, sink trap water, toilet bowls) Carbapenem-resistant Enterobacteriaceae Whole Genome Sequencing single nucleotide variation 268 clinical isolates
927 environmental samples
April 2014–December 2014 General wards [21]
 Sink faucet aerators Carbapenem-resistant Pseudomonas aeruginosa Amplified Fragment Length Polymorphisms 46 unique patients
236 environmental samples
February 2009 – January 2012 Intensive care unit [22]
 Sink drains (drainage pipe in the wall) Metallo-β-lactamase-producing Pseudomonas aeruginosa Pulsed-field gel electrophoresis 14 unique patients
Environmental samples from 12 sink drain in patients’ rooms
2008–2014 General wards [23]
 Sink faucets, water samples (Hospital plumbing infrastructure) Multidrug-resistant Sphingomonas koreensis Whole Genome Sequencing Average nucleotide identity 12 unique patients
Environmental samples (Sinks, faucets, pipes, valves, aerators, other plumbing fixtures)
2006–2016 Intensive care unit and General wards [24]
Dry Environmental Surfaces
 Bedside Extensively drug-resistant Acinetobacter baumannii Rep-PCR 8 unique patient samples
An unknown number of non-clinical samples
March–May 2014 Intensive care unit [36]
 Patient Environment OXA-48-Enterobacteriaceae
MDR Acinetobacter baumannii
Clone specific PCR 13 OXA-48 producing Enterobacteriaceae
18 MDR A. baumannii
An unknown number of non-clinical samples
July–October 2015 Intensive care unit [37]
Medical equipment and other appliances
 Velcro of blood pressure cuffs Carbapenem-resistant Acinetobacter baumanii (CRAB) Pulsed-field gel electrophoresis 20 unique patient samples First round: 222 environmental samples Second round: 97 environmental samples (including 2 blood pressure cuffs velcro and 13 healthcare workers) December 2011 – April 2012 Intensive care unit [48]
 Positioning pillow Carbapenem-resistant Klebsiella pneumoniae Whole Genome Sequencing, Multilocus Sequence Typing (rpoB, gapA, mdh, pgi, phoE, infB and tonB) 89 unique patient samples, 1030 environmental samples, 24 miscellaneous samples (animals, surrounding hospitals, other countries) July 2010 – April 2013 Intensive care unit and general wards [49]
 Ice machine Carbapenem-resistant Acinetobacter baumannii Multilocus Sequence Typing, Rep-PCR 20 unique patient samples, ~ 75 non-clinical samples (50 environmental, ~ 10 from 2 ice machines, 15 HCWs) September 2015 Spinal Cord Unit [50]
 Cold tea dispenser Carbapenem-resistant Enterobacteriaceae Whole Genome Sequencing, Multilocus Sequence Typing 145 unique patient samples, 195 environmental samples May 2014 – December 2014 Paediatric wards [52]