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An outbreak of Ralstonia insidiosa bloodstream infections caused by contaminated heparinized syringes
Nazmiye Ülkü Tüzemen1, Uğur Önal2, Esra Kazak2
1Department of Medical Microbiology, Bursa Uludag University, Faculty of Medicine, Bursa, Turkey.
Introduction:
Ralstonia insidiosa, a gram-negative waterborne bacteria able to survive and grow in any type of water source, can cause nosocomial infections, and are considered emerging pathogens of infectious diseases in hospital settings. In this study, we report an outbreak of R. insidiosa at our center related to contaminated heparinized syringes.
Material And Methods:
The present study was conducted in a tertiary care university hospital in Turkey. An outbreak analysis was performed between September 2021 and December 2021. Microbiological samples were obtained from environmental sources and from patient blood cultures. Species identification was performed using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). To investigate the clonality of strains, all confirmed isolates were sent to the National Reference Laboratory and pulsed-field gel electrophoresis (PFGE) was used to perform molecular typing.
Results:
Seventeen R. insidiosa isolates were identified from the blood cultures of 13 patients from various wards and intensive care units. Isolates from seven patient blood cultures and two heparinized blood gas syringes were characterized by PFGE. All isolates were found to belong to the same clone of R. insidiosa.
Conclusion:
R. insidiosa was identified as the cause of a nosocomial infection outbreak in our hospital, which was then rapidly controlled by the infection-control team. When rare waterborne microorganisms grow in blood or other body fluid cultures, clinicians and the infection-control team should be made aware of a possible outbreak.
Insights
A Ralstonia insidiosa outbreak in a hospital was linked to contaminated syringes. The infection-control team identified the outbreak and implemented control measures, highlighting the need for vigilance with rare waterborne pathogens.
Area of Science:
- Microbiology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Ralstonia insidiosa is an emerging gram-negative, waterborne pathogen.
- This bacterium can cause nosocomial infections in healthcare settings.
- An outbreak was linked to contaminated heparinized syringes.
Purpose of the Study:
- To report and analyze an outbreak of Ralstonia insidiosa.
- To identify the source of the nosocomial infection.
- To evaluate the effectiveness of infection control measures.
Main Methods:
- Outbreak analysis conducted in a tertiary care university hospital.
- Microbiological sampling from environmental sources and patient blood cultures.
- Species identification using MALDI-TOF MS and molecular typing via PFGE.
Main Results:
- Seventeen Ralstonia insidiosa isolates were identified from 13 patients.
- Isolates from patient blood cultures and heparinized syringes belonged to the same clone.
- The outbreak was rapidly controlled by the infection-control team.
Conclusions:
- Ralstonia insidiosa caused a nosocomial outbreak linked to contaminated syringes.
- Clinicians and infection control teams must be aware of potential outbreaks from rare waterborne microorganisms.
- Prompt identification and control measures are crucial for managing such outbreaks.
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