Over the past four years, an investigation across California hospitals has linked ice and water use in clinical settings to potential infections. The CDC’s MMWR Morb Mortal Wkly Rep reported that between 2021 and 2022, 23 cases of infections caused by Burkholderia multivorans (sequence type ST659) were reported at two hospitals in Southern California, attributed to contaminated ice and water from these machines. To manage the outbreak, public health officials advised stopping the use of ice and tap water during clinical care activities, and an investigation is underway to identify potential sources of contamination in the ice machines.1.