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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

SitesOrganismsMolecular methodsNumber of SamplesTimeSettingRef
Aqueous environment
 Sinks and ultra-filtrate bagsMultidrug-resistant Pseudomonas aeruginosaRepetitive element palindromic polymerase chain reaction (Rep-PCR)21 unique patients
Environmental samples from 5 sinks
Jan 2012 – February 2014Intensive care unit[18]
 Plumbing (Shower drains, sink taps, sink drain tailpieces, sink drain strainers, sink trap water, toilet bowls)Carbapenem-resistant EnterobacteriaceaeWhole Genome Sequencing single nucleotide variation268 clinical isolates
927 environmental samples
April 2014–December 2014General wards[21]
 Sink faucet aeratorsCarbapenem-resistant Pseudomonas aeruginosaAmplified Fragment Length Polymorphisms46 unique patients
236 environmental samples
February 2009 – January 2012Intensive care unit[22]
 Sink drains (drainage pipe in the wall)Metallo-β-lactamase-producing Pseudomonas aeruginosaPulsed-field gel electrophoresis14 unique patients
Environmental samples from 12 sink drain in patients’ rooms
2008–2014General wards[23]
 Sink faucets, water samples (Hospital plumbing infrastructure)Multidrug-resistant Sphingomonas koreensisWhole Genome Sequencing Average nucleotide identity12 unique patients
Environmental samples (Sinks, faucets, pipes, valves, aerators, other plumbing fixtures)
2006–2016Intensive care unit and General wards[24]
Dry Environmental Surfaces
 BedsideExtensively drug-resistant Acinetobacter baumanniiRep-PCR8 unique patient samples
An unknown number of non-clinical samples
March–May 2014Intensive care unit[36]
 Patient EnvironmentOXA-48-Enterobacteriaceae
MDR Acinetobacter baumannii
Clone specific PCR13 OXA-48 producing Enterobacteriaceae
18 MDR A. baumannii
An unknown number of non-clinical samples
July–October 2015Intensive care unit[37]
Medical equipment and other appliances
 Velcro of blood pressure cuffsCarbapenem-resistant Acinetobacter baumanii (CRAB)Pulsed-field gel electrophoresis20 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 2012Intensive care unit[48]
 Positioning pillowCarbapenem-resistant Klebsiella pneumoniaeWhole 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 2013Intensive care unit and general wards[49]
 Ice machineCarbapenem-resistant Acinetobacter baumanniiMultilocus Sequence Typing, Rep-PCR20 unique patient samples, ~ 75 non-clinical samples (50 environmental, ~ 10 from 2 ice machines, 15 HCWs)September 2015Spinal Cord Unit[50]
 Cold tea dispenserCarbapenem-resistant EnterobacteriaceaeWhole Genome Sequencing, Multilocus Sequence Typing145 unique patient samples, 195 environmental samplesMay 2014 – December 2014Paediatric wards[52]