Outbreak of Infusion-Related Septicemia by Ralstonia Pickettii in the Oncology Department

Abstract

Hospital acquired blood stream infection by Ralstonia pickettii in 9 cancer patients related to the heparin solution contamination used to flush the central venous catheter.

An Outbreak of Ralstonia pickettii Bloodstream Infection Associated with an Intrinsically Contaminated Normal Saline Solution

“…5,9 In particular, this pathogen is more likely to cause infection in patients with impaired immune systems. 7,14,17,18 Among our 30 cases, the most frequent diagnoses were neoplasms (86.7%), and 20 of these patients were undergoing chemotherapy.…”

“…[12][13][14] In our hospital, a total of 4 blood specimens from 4 patients were culture positive for R. pickettii within 1 week. We conducted clinical epidemiological and microbiological investigations to identify possible sources of infection and to block the route of infection to end the outbreak.…”

Antimicrobial susceptibility of uncommonly isolated non-enteric Gram-negative bacilli

“…R. pickettii is a infrequent cause of a variety of infections, including bacteraemia, endocarditis, meningitis, and osteomyelitis. It has been identified in several outbreaks due to the contamination of intravenous products, 'sterile' water, saline, chlorhexidene solutions, respiratory therapy solutions and intravenous catheters [56][57][58]. It has also been associated with pseudobacteraemias and asymptomatic colonisation [59,60].…”

Monoclonal outbreak of catheter-related bacteraemia by Ralstonia mannitolilytica on two haemato-oncology wards

“…9 Therefore, many of the cases of infection with R. pickettii were due to contaminated water or aqueous solutions given intravenously. 5,6,10,11 Interestingly, even ''sterile'' medical products like ranitidine 12 and saline solution 13,14 were reported to be contaminated with R. pickettii. Several infections of patients with permanent indwelling intravenous devices like central venous catheters or Port-A-Caths have been described.…”