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

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Research Paper 01/11/2021
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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.
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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.


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