An outbreak of Ralstonia pickettii bloodstream infection and clinical outcomes

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Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
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Şirin Menekşe1, Demet Hacıseyitoğlu2, Serap Süzük Yıldız3

  • 1Department of Infectious Diseases, Koşuyolu Kartal Heart Training and Research Hospital, İstanbul, Turkey. meneksesirin@hotmail.com.

Journal of Infection in Developing Countries
|May 11, 2022
PubMed
Abstract

Insights

A hospital outbreak of Ralstonia pickettii (R. pickettii) infections, initially misidentified as Ralstonia insidiosa, affected 22 patients. The infections were mild, with fever as the only symptom, and no mortality occurred.

Area of Science:

  • Clinical Microbiology
  • Infectious Diseases
  • Hospital Epidemiology

Background:

  • Ralstonia pickettii (R. pickettii) infections are uncommon and can be misdiagnosed.
  • Hospital outbreaks of R. pickettii are rare and pose diagnostic challenges.

Purpose of the Study:

  • To report a hospital outbreak of R. pickettii infections.
  • To describe the clinical consequences and initial misidentification of the outbreak.
  • To investigate the source and spread of R. pickettii within a tertiary hospital.

Main Methods:

  • A bacteraemia outbreak was investigated between August and October 2019.
  • Isolates were identified using VITEK 2 Compact and MALDI-TOF MS.
  • Genomic DNA typing was performed using pulsed-field gel electrophoresis.
  • Potential sources, including commercial products, were examined.

Main Results:

  • Twenty-two patients in intensive care units developed R. pickettii bacteraemia.
  • Initial identification by VITEK 2 Compact misidentified R. pickettii as R. insidiosa.
  • Sterile distilled water samples yielded R. pickettii, but the source remained unconfirmed.
  • All patients presented with fever; no clinical deterioration or mortality was observed.

Conclusions:

  • Ralstonia pickettii infections during this outbreak exhibited low virulence.
  • Prompt and accurate identification using MALDI-TOF MS is crucial for managing R. pickettii outbreaks.
  • Despite challenges in source identification, the clinical course was mild, suggesting a need for further research into R. pickettii virulence factors.
Keywords:
Ralstonia pickettiihospital outbreaklow virulence

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