Nosocomial bloodstream infection and the emerging carbapenem resistant pathogen Ralstonia mannitolilytica: A case series

Paper Details

Research Paper 01/11/2021
Views (548) Download (33)
current_issue_feature_image
publication_file

Nosocomial bloodstream infection and the emerging carbapenem resistant pathogen Ralstonia mannitolilytica: A case series

Sofiya Rabye, Leela Rania, Renuka
Int. J. Micro. Myco.13( 5), 1-7, November 2021.
Certificate: IJMM 2021 [Generate Certificate]

Abstract

Ralstonia mannitolilytica (RM) is a rare opportunistic pathogen capable of causing a serious infection in immunocompromised patients, especially oncology patients with prolonged presence of indwelling central catheters. Gram negative non fermenting bacteria are an emerging concern in clinical locations being a common cause of nosocomial infections. In this study, we report a case series of RM infection with focus on common clinical characteristics and patterns of their antibiotic sensitivity and resistance pattern with specific stress on Carbapenem resistance. The case series includes 12 patients admitted at Vydehi Institute of medical college and research centre Bangalore, presenting with fever, chills and other signs of infection between 4th October 2020 to 21nd February 2021 who had positive blood culture and PICC/central venous catheter (CVC) tip culture positive for RM species. Out of 12 patients RM was grown in blood sample of 7 patients with central venous catheter, 3 with indwelling chemo Port, 2 with PICC line. All the patient’s blood culture was positive for RM with same resistance pattern. In conclusion our study shows that RM is a new emerging carbapenem resistant gram-negative organism which can be life threatening especially in immunocompromised patients. Its incidence must immediately warrant an active search for source of contamination. This could be an indirect indicator of quality of water reservoir and other supplies used in these patients. The sensitivity pattern of RM being resistant to many routinely used antibiotics, even carbapenems. The case series serves an alert for medical workers and researchers to pay more attention to infection caused by RM.

VIEWS 78

Basso MC, Venditti G, Raponi AS. 2019. Navazio-Infection and drug, and undefined 2019. n.d. “A Case of Persistent Bacteraemia by Ralstonia mannitolilytica and Ralstonia pickettii in an Intensive Care Unit.” Ncbi.Nlm.Nih.Gov. Accessed June 6, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles

Dotis, John, Nikoleta Printza, Anagnostina Orfanou, Evangelia Papathanasiou, and Fotios Papachristou. 2012. “Peritonitis due to Ralstonia mannitolilytica in a pediatric peritoneal dialysis patient.” New Microbiologica 35(4), 503-6.

Fang, Qingqing, Yu Feng, Ping Feng, Xiaohui Wang, and Zhiyong Zong. 2019. “Nosocomial bloodstream infection and the emerging carbapenem-resistant pathogen Ralstonia insidiosa.” BMC Infectious Diseases 19(1). https://doi.org/10.1186/s12879-019-3985-4.

Koneman, EWSD, Allen WM. 2021. Janda gram-negative bacilli, and undefined 1997. n.d. “Diagnostic Microbiology.” Ncbi.Nlm.Nih.Gov. Accessed June 6, 2021. https://www.ncbi.nlm.v nih.gov/pmc/articles/PMC1916389/pdf/amjpathol00192-0158.pdf.

Lim, Christopher Thiam Seong, and Sut Enn Lee. 2017. “A Rare case of Ralstonia mannitolilytica Infection in an end stage renal patient on maintenance dialysis during municipal water contamination.” Pakistan Journal of Medical Sciences 33(4), 1047-49.

Liu, Cai Xia, Chun Yan, Pan Zhang, Fang Qu Li, Jing Hong Yang, and Xiang Yang Li. 2016. “Ralstonia mannitolilytica induced septicemia and homology analysis in infected patients: 3 Case Reports.” Jundishapur Journal of Microbiology 9(7). https://doi.org/10.5812/jjm.34373.

Lucarelli, Claudia, Enea Gino Di Domenico, Luigi Toma, Domenico Bracco, Grazia Prignano, Maria Fortunati, Lorella Pelagalli. 2017. “Ralstonia mannitolilytica infections in an oncologic day ward: Description of a Cluster among high-risk patients.” Antimicrobial Resistance and infection control 6(1). https://doi.org/10.1186/s13756-017-0178-z.

Mukhopadhyay CA. 2021. Bhargava- Indian journal of, and undefined 2003. n.d. “Ralstonia mannitolilytica infection in renal transplant recipient: First Report.” Pubmed. Ncbi. Nlm. Nih. Gov. Accessed June 6, 2021. https://pubmed. ncbi.nlm.nih.gov/17643046/.

Ramani, Vinod K, Ganesha DV, Vinu Sarathy, Somorat Bhattacharjee, Shobha Ganeshan, Radheshyam Naik. 2021a. “Outbreak of Ralstonia mannitolilytica infection at a tertiary care oncology center in south india: A Case Series.” Asian Pacific Journal of Cancer Biology 6(1), 87-92. https://doi.org/10.31557/APJCB.20.

2021b. “Outbreak of Ralstonia mannitolilytica infection at a tertiary care oncology center in south india: A case series.” Asian Pacific Journal of Cancer Biology 6(1), 87-92. https://doi.org/10.31557/apjcb.2021.6.1.87.

Ryan, Michael P, Tony Pembroke J. 2018. “Brevundimonas Spp: Emerging Global Opportunistic Pathogens. Virulence 9(1). 480-93. https://doi.org/10.1080/21505594.2017.141