Fig. 3

Patient flow maps during the first (a) and the second (b) clusters showing the transfers of clustered patients (arrows) between wards. The cluster is represented in red heat map layer with the occurrences of patients harbouring CRKp complex during the 2nd semester 2014 (first cluster) and the 4th quarter 2015 to 1st semester 2016 (second cluster). Patient numbers are in blue circles ordered by the date of the first detection, including the first detected case in the pre-cluster period of the first cluster (patient#1). The blue and red arrows represent the transfer of a clustered patient, respectively, before and after the first detection of CRKp complex isolate. The black arrow represents the opportunity for bacteria transmission between patients, considering the admission ward or unit and hospitalisation period after the first detection. While dashed blue arrow in (b) has the meaning to demonstrate that these units work together as the same ICU. Patients #1 and #8 in the first cluster and patients #2, #14 and #15 in the second group never moved to another ward and, among them, only patient #8 had the direct opportunity to acquire the bacteria from another clustered patient (patient #2) hospitalised in the same period at the same ward (#400)