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Two Consecutive Outbreaks of Stenotrophomonas Maltophilia (Xanthomonas Maltophilia) in an Intensive-care Unit Defined by Restriction Fragment-Length Polymorphism Typing

  • Nancy Alfieri (a1), Karam Ramotar (a2), Pamela Armstrong (a1), Mary E. Spornitz (a1), Glenda Ross (a1), James Winnick (a1) and D. Roy Cook (a1)...

To investigate and control consecutive outbreaks of Stenotrophomonas maltophilia infections in intensive-care–unit (ICU) patients.


Epidemiological investigation; restriction fragment-length polymorphism typing by pulsed-field gel electrophoresis (PFGE) of genomic DNA of outbreak strains; institution of infection control measures to limit spread.


The medical-surgical ICU in an 800-bed tertiary-care center in Calgary, Alberta, Canada.


S maltophilia was recovered from 14 ICU patients (12 infected, 2 colonized) between February 1993 and February 1994. Ten of the 14 patient isolates and 1 environmental isolate were available for PFGE typing. Patient isolates from 6 of the first 10 patients were identical. Isolates from the next 3 of 4 patients and an isolate recovered from a ventilator being used by a patient not infected with S maltophilia also were identical, but different from the first 6. The ventilator isolate was temporally associated with the latter 4 patients.


Molecular typing allowed us to determine that there were two separate consecutive S maltophilia outbreaks rather than a single protracted outbreak. Recovery of S maltophilia from patient ventilators and an in-line suction catheter suggests that the organism may have been spread by cross-contamination from contaminated equipment or from an environmental source.

Corresponding author
Infection Control, Calgary District Hospital Group, 7007–14 St SW, Calgary, Alberta T2V 1P9, Canada
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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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