Ralstonia pickettii as an emerging pediatric pathogen: a mini-review of current evidence

Area of Science:

• Pediatric Infectious Diseases
• Clinical Microbiology
• Environmental Health

Background:

• Ralstonia pickettii (R. pickettii) is increasingly significant in pediatric healthcare.
• Its persistence in water systems, biofilm formation, and contamination of medical solutions pose risks.
• This review addresses R. pickettii's epidemiology, reservoirs, clinical aspects, diagnostics, and treatment in children.

Purpose of the Study:

• To review current evidence on Ralstonia pickettii in pediatric healthcare.
• To summarize its epidemiology, environmental reservoirs, clinical features, diagnostic challenges, and therapeutic strategies.
• To highlight R. pickettii as an emerging pathogen in pediatric care.

Main Methods:

• A narrative literature search was performed across major databases (PubMed, Scopus, Web of Science, Embase) from January 1990 to November 2025.
• Included studies focused on pediatric cases, outbreaks, clinically relevant environmental findings, and microbiological reviews.
• A narrative synthesis was employed due to study heterogeneity.

Main Results:

• R. pickettii is the primary Ralstonia species in pediatric infections, often associated with contaminated aqueous products and respiratory equipment.
• Neonates and immunocompromised children are most vulnerable, experiencing outcomes from colonization to sepsis.
• Diagnostic errors are common; molecular methods improve accuracy with clinical correlation. Treatment requires targeted therapy and device removal, with outbreaks linked to contaminated solutions and water systems.

Conclusions:

• Ralstonia pickettii represents an emerging threat in pediatric settings.
• Enhancing diagnostic accuracy is vital.
• Strengthening environmental controls and ensuring safe handling of medical devices and water-based solutions are essential for reducing clinical impact.