Fig. 2.

Outbreaks containing at least one definite or probable nosocomial case. (A) Using epidemiological data alone (nodes are linked purely using ward-based contacts) isolated grey nodes indicate individuals in a genomic but not epidemiologically-defined outbreak, (B) Using both epidemiological data and genomic data (nodes are linked both epidemiologically and genomically), isolated nodes indicate individuals in an epidemiological but not genomic outbreak.

Each node represents an individual, all individuals in an epidemiological or genomic outbreak are shown in panel A with the sequenced subset in panel B. Node colours indicate the epidemiological group, grey nodes were not assigned to an epidemiological group. Lines indicate ward contact within an outbreak, line length is insignifiant.

This demonstrates that epidemiological outbreaks consist of multiple genomic outbreaks and individual introductions, and conversely genomic outbreaks span multiple wards/epidemiological outbreaks. 69/176 (39%) nosocomial cases were not sequenced.