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Infection control policies must now consider this threat of transmission between non-CF and CF patients.

is a nutritionally versatile, gram-negative organism, commonly found in soil and water.

Analysis by ribotype (ribosomal RNA operon-associated) restriction fragment length polymorphisms (RFLPs) and pulsed-field gel electrophoresis (PFGE)—resolved chromosomal RFLP profiles confirm that several distinct highly transmissible CF-associated clones exist [6, 7].

There are also numerous strains of negligible transmissibility [8].

Case-control and cohort studies were carried out to investigate the potential risk factors for acquisition and the mortality associated with acquisition.

Environmental microbiologic studies were performed to identify potential reservoirs and modes of transmission.

The precise mode of spread of highly transmissible strains has not been determined, but social contact between CF patients appears to be an important factor [9].

Two distinctly different categories of outbreaks have been reported: outbreaks that occur and persist in the CF community due to cross-spread of highly transmissible CF-associated strains [7, 9, 10] and the small, short-lived focal outbreaks that occur in non-CF patients due to nosocomial acquisition from a contaminated common source [11–13].

MICU, PICU, and CCU patients were affected soon after.

Phylogenic analysis suggests that it has evolved independently and that such highly transmissible strains can emerge rapidly and randomly.

Acquisition risk in the CF patients was linked to hospitalization (odds ratio = 5.47, = .0158, confidence interval = 1.28–26.86) and was associated with significantly increased mortality rates.

Specimens were obtained from mechanical ventilators, ambu bags, blood pressure cuffs, sink drains, handles and faucets, laryngoscope blades, hand soaps, mouthwash, antiseptics, irrigant solutions, and wheelchairs by sterile swabs streaked onto PC agar.

Hand cultures of personnel were not studied, as survival of -based phylogenic tree was inferred by Dollo parsimony methods [7, 19].

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