Following an outbreak linked to water supply, what surveillance plan change is recommended?

• A. Monitor the water supply for atypical mycobacteria
• B. Expand SSI surveillance to all surgeries
• C. Screen for MRSA in all patients
• D. Increase hand hygiene audits

Answer: (A)

When an outbreak is linked to a water supply, the main aim is to identify and monitor the source of contamination in the water system. Monitoring the water supply for atypical mycobacteria is the best move because these organisms commonly inhabit hospital plumbing and biofilms, are resistant to standard disinfectants, and can cause infections when patients are exposed through water sources. Detecting their presence in the water helps confirm the source, quantify contamination, and direct targeted remediation like system cleaning or disinfection, followed by ongoing environmental monitoring to prevent recurrence.

Other options don’t address the water source directly: expanding surveillance to all surgeries shifts focus away from the contaminated water; screening all patients for MRSA targets a skin carriage issue unrelated to the water supply; and simply increasing hand hygiene audits improves general practices but doesn’t identify or control the waterborne reservoir.