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Septic Shock After Kidney Transplant: A Rare Bloodstream Ralstonia mannitolilytica Infection

Xiangyong Tian1, Nan Jing2, Wenjing Duan3

  • 1Department of Urology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, People's Republic of China.

Infection and Drug Resistance
|July 28, 2022
PubMed
Abstract

Insights

Ralstonia mannitolilytica is a rare cause of septic shock in kidney transplant recipients (KTRs). Early detection via blood cultures and targeted antibiotics are crucial for successful treatment and recovery.

Area of Science:

  • Infectious Diseases
  • Transplant Medicine
  • Microbiology

Background:

  • Ralstonia mannitolilytica is an emerging opportunistic pathogen.
  • It primarily affects immunocompromised individuals.
  • Severe sepsis and septic shock are rare but serious complications in kidney transplant recipients (KTRs).

Observation:

  • A 41-year-old male kidney transplant recipient developed septic shock.
  • Initial metagenomic next-generation sequencing (mNGS) yielded negative results.
  • Blood cultures and mass spectrometry confirmed Ralstonia mannitolilytica as the causative agent.

Findings:

  • The patient was successfully treated with sulfamethoxazole-trimethoprim, amikacin, and piperacillin-tazobactam based on drug sensitivity.
  • A 6-month follow-up showed a satisfactory recovery with no complications.
  • Ralstonia mannitolilytica can be an overlooked cause of septic shock in KTRs.

Implications:

  • Highlights the importance of considering Ralstonia mannitolilytica in KTRs with septic shock.
  • Emphasizes the need for thorough medical history and close monitoring of inflammatory markers.
  • Stresses the continued importance of traditional blood cultures and cautious interpretation of negative mNGS results.
Keywords:
Ralstonia mannitolilyticablood cultureskidney transplantmNGSmetagenomic next-generation sequencingsepsis

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