In the old hospital building, 10 two-person rooms, 15 four-person rooms, four isolation rooms with anteroom, three hematology rooms with anteroom, 10 ICU rooms, of which two with anteroom, and nine bathrooms were sampled. Two hematology rooms were located at the Cancer Institute. Of the sampled bathrooms, one belonged to a hematology room and one to an isolation room. In Supplementary file 1, the medical specialty corresponding to the sampled patient rooms and bathrooms is described. New hospital building The new hospital building consisted of 503 single-occupancy rooms with private bathrooms, 22 isolation rooms with anterooms and private bathrooms, and 56 single-occupancy adult ICU rooms. While isolation rooms in the old hospital building where located at one ward, isolation rooms in the new building were located at multiple wards in the hospital building. In the new hospital building, 30 single-occupancy rooms, of which three hematology and four isolation rooms, all with anterooms; 10 ICU rooms, of which two with anteroom; and 10 bathrooms were sampled. Bathrooms sampled in the new building belonged to eight included single-occupancy rooms, one included hematology room, and one included isolation room (Supplementary file 1). Rooms were selected before the start of sampling and the same rooms were sampled during each sampling moment, unless it was not possible to enter the room (e.g. patient was in a clinically unstable condition or was admitted with an indication for isolation in a normal patient room). In these circumstances, a nearby patient room was sampled. Sample sites Sample sites in patient rooms were the nightstand, table, wall, sink, and the top and bottom of the sink plug (Supplementary file 2). When multiple nightstands or tables were present in a patient room, all were sampled. In four-person rooms, two locations on the wall were sampled. Sample sites in bathrooms were the toilet seat, shower chair, shower drain, door handle on the inside of the bathroom, the sink, and the top and bottom of the sink plug (Supplementary file 2). Sink plugs were installed in 2013 in six wards, including the ICU, as an IPC measure, to prevent splashing of water from the sink drain. In the old building, sink plugs were not present in 31 sinks. When not present, the top of the sink drain was sampled, which was considered the same sample site as the bottom of the sink plug for analyses. In the new hospital building, a sink plug was present in all sinks, with the exception of one sampled bathroom sink, where the top of the sink drain was sampled. In rooms with an anteroom (e.g. hematology and isolation rooms), the sink was located in the anteroom instead of in the patient room. Furthermore, in both the old and the new hospital building, two ICU rooms had a sink in the anteroom and a sink in the patient rooms. For these rooms, both the sink and sink plug in the anteroom, as well as the sink and sink plug in the patient room were sampled. Sampling methods To determine the total number of CFUs, Replicate Organism Direct Agar Contact-plates (RODAC) with Trypticase Soy Agar (TSA) with Lecithin and Polysorbate 80 (Bruker Daltonics, Bremen, Germany) were used. Of all sample sites, one RODAC per sampling moment was 3 151 Environmental contamination with MDRO in single-occupancy rooms
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