Outbreak of Stenotrophomonas maltophilia bacteremia among patients undergoing bone marrow transplantation: Association with faulty replacement of handwashing soap

Using molecular typing methods, we confirmed an outbreak of Stenotrophomona s maltophilia among bone marrow transplant patients. The likely source was a healthcare worker who may have washed with moisturizer instead of soap be tween patients. Hospital epidemiologists need to go beyond antibiograms whe n evaluating outbreaks and be vigilant about all aspects of hand washing.