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However, contamination in areas away from isolated patients remains inadequately characterized, and local epidemiological data are limited. A comprehensive surveillance study was conducted in the ICU of a tertiary hospital from January 2019 to December 2022. Monthly collections included clinical specimens (sputum, urine, blood) and environmental samples (inanimate surfaces, healthcare workers\u2019 hands). Gram-negative bacteria were cultured, and carbapenem sensitivity testing was performed. Among 5,097 clinical specimens collected over the 4-year study period, 898 (17.6%) GNB isolates and 405 (8.0%) CR-GNB isolates were detected, with\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    and carbapenem-resistant\n                    <jats:italic>Acinetobacter baumannii<\/jats:italic>\n                    (CRAB) being the most common species. From 2,215 environmental samples, 144 (6.5%) GNB and 90 (4.1%) CR-GNB strains were identified, predominantly\n                    <jats:italic>A. baumannii<\/jats:italic>\n                    and CRAB. The overall CR-GNB environmental contamination rates were highest on work coats (6.8%), followed by nonisolated patient medical devices (5.8%), nonisolated patient bed units (4.3%), mobile phones (4.1%), doctors\u2019 offices and nurses\u2019 stations (3.6%), and healthcare workers\u2019 hands (2.0%). Spearman\u2019s correlation analysis revealed a significant positive correlation between the monthly number of positive\n                    <jats:italic>A. baumannii<\/jats:italic>\n                    or CRAB isolates from environmental samples and clinical specimens. CR-GNB, particularly CRAB, contaminates ICU environments, including nonisolated patient areas and healthcare stations, highlighting the need for enhanced environmental surveillance in the ICU.\n                  <\/jats:p>","DOI":"10.1038\/s41598-025-30256-2","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T14:33:50Z","timestamp":1767105230000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Environmental contamination of carbapenem-resistant gram-negative bacteria away from isolated patients in intensive care unit: a comprehensive surveillance study"],"prefix":"10.1038","volume":"16","author":[{"given":"Pan","family":"Xiao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui-Chao","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"An-Hua","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xun","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun-Hui","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei-Yun","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Si-Di","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"30256_CR1","doi-asserted-by":"publisher","first-page":"e0108121","DOI":"10.1128\/spectrum.01081-21","volume":"10","author":"W Zhai","year":"2022","unstructured":"Zhai, W. et al. 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All participants in this study provided informed consent prior to their involvement. The purpose, procedures, potential risks, and benefits of the research were clearly explained in both written and verbal formats. Participants were informed of their right to withdraw from the study at any time without penalty. This study was performed in line with the principles of the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}],"article-number":"680"}}