Primary and secondary literature should be distinguished when searching for data used in systematic reviews of nosocomial outbreaks.

typing analysis, which would contribute to the knowledge of the molecular epidemiology of CRAB isolates. Although many distinct sequence types of CRAB, including some international clones, have been identified in Brazil, there still are no data from this Brazilian region. In summary, we demonstrated the persistence of a few clones responsible for endemic levels of CRAB isolates in hospitals in a Brazilian city. Notably, 3 of 7 clones remained as the major strains at least 5 years after an initial outbreak in this city. These findings challenged the effectiveness of infection control measures to control the dissemination of CRAB after an initial large outbreak.