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Point/Counterpoint Editorials |

Point: Does the Risk of Cross Infection Warrant Exclusion of Adults With Cystic Fibrosis From Cystic Fibrosis Foundation Events? YesRisk of Cystic Fibrosis Cross Infection? Yes

Manu Jain, MD; Lisa M. Saiman, MD, MPH; Kathy Sabadosa, MPH; John J. LiPuma, MD
Author and Funding Information

From the Department of Medicine and Pediatrics (Dr Jain), Feinberg School of Medicine, Northwestern University; Department of Pediatrics (Dr Saiman), Columbia University Medical Center; Department of Infection Prevention and Control (Dr Saiman), New York-Presbyterian Hospital; Dartmouth Institute for Health Policy & Clinical Practice (Ms Sabadosa), Geisel School of Medicine; and the Department of Pediatrics and Communicable Disease (Dr LiPuma), University of Michigan Medical School.

Correspondence to: Manu Jain, MD, Northwestern University, 240 E Huron M-332, Chicago, IL 60611; e-mail: m-jain@northwestern.edu


Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr Saiman receives funding from the CF Foundation to provide expertise in infectious diseases and microbiology. Ms Sabadosa is a full-time, 10-year employee of the Cystic Fibrosis Foundation. Drs Jain and LiPuma have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(4):678-680. doi:10.1378/chest.13-2404
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In 1990, LiPuma and colleagues1 described person-to-person transmission of Pseudomonas cepacia (now Burkholderia cepacia) between young adults with cystic fibrosis (CF) attending an educational program. One of the newly infected individuals had been previously in good health, but deteriorated rapidly and died within several months. This tragic case highlights the potential for catastrophic consequences from person-to-person transmission of bacterial pathogens in CF. This report and others from around the world that also described person-to-person transmission of B cepacia associated with acceleration of pulmonary disease and death led to the recommendation that people infected with B cepacia not attend Cystic Fibrosis Foundation (CF Foundation)-sponsored events. Reports describing person-to-person transmission of other more prevalent CF pathogens, most notably Pseudomonas aeruginosa, soon followed. In response, the CF Foundation published recommendations for infection prevention and control in 2003.2 Over the last 10 years, accumulating evidence has described further instances of person-to-person transmission of CF pathogens as well as poor clinical outcomes associated with transmission of certain strains of P aeruginosa, methicillin-resistant Staphylococcus aureus (MRSA), and Burkholderia.3 In response, the CF Foundation commissioned an update of the guidelines and invited public comment on a draft version. The period for public comment is now closed.

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