Introduction Inanimate surfaces in hospitals may be contaminated with nosocomial pathogens, such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), carbapenemase-producing Enterobacterales (CPE), Pseudomonas spp. and Acinetobacter spp. (1). These pathogens play an important role in the acquisition of healthcare associated infections (HAI) via direct or indirect contact with the contaminated surface (1, 2). An analysis of 1561 nosocomial outbreaks showed that the hospital environment was the source in almost 20% of those outbreaks, highlighting the importance of the environment (3). Next to identifying the source of an outbreak and apart from sampling for research aims, monitoring the environment can be used to routinely determine the presence of nosocomial pathogens, or to evaluate cleaning efficacy. Nevertheless, there are no national or international guidelines on when and how to perform environmental sampling (4, 5). Therefore, with this current survey study, we aimed to provide insights on current environmental sampling practices of the innate environment and the laboratory methods used to process these samples. Methods Study design A web-based survey in the English language was developed and opened for responses between August 6th, 2021, and December 20th, 2021. Before releasing the survey, it was piloted in two centers. The survey was distributed digitally amongst members of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Nosocomial Infections (ESGNI), the Healthcare Infection Society (HIS), and members of the European Network to Promote Infection Prevention for Patient Safety (EUNETIPS), who forwarded the survey to the members of their respective societies. Survey questions The survey consisted of three sections and asked specifically about sampling practices for MRSA, VRE, CPE, Pseudomonas spp., and Acinetobacter spp. (Supplementary Appendix). The first section focused on the respondent and their role in environmental sampling, the second section on sampling practices, and the third section on sample processing methods. A distinction was made between indirect and direct sampling methods. Indirect methods included sponges, wipes, cotton swabs, flocked swabs and cotton swabs; direct methods included contact plates, dip slides and petrifilm. Before proceeding to the second and third sections, respondents were asked if they could answer these questions. If they answered ‘no’, they were redirected to the next section of the survey. It was not mandatory to answer all questions. All questions consisted of multiple answer options from which to choose one, except for one question where the answer was in free text. 3 131 Environmental sampling practices of innate hospital surfaces
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