Ralstonia mannitolilytica sepsis: a case report

Abstract

BackgroundRalstonia mannitolilytica is an emerging opportunistic pathogen that is associated with severe disease, including septic shock, meningitis, and renal transplant infections. Reports on this pathogen are limited, however, especially on the African continent.Case presentationA 2-year-old Akan child was presented to a hospital in the northeastern part of Ghana with a 1-week history of fever and chills. We identified Ralstonia mannitolilytica in her blood culture using both conventional and 16S ribosomal deoxyribonucleic acid (rDNA) techniques. The patient’s condition improved clinically upon treatment with cefuroxime.ConclusionOur report highlights the potential of Ralstonia mannitolilytica to cause sepsis and thus emphasizes the need for improved laboratory diagnosis and evidence for use of appropriate antibiotics in rural settings of Africa, where presumptive treatment using antimicrobial agents is rife.

A Rare Case of Ralstonia pickettii Infection in a Patient Undergoing Thyroid Surgery

“…We conducted a comprehensive literature review to determine circumstances under which Ralstonia was linked to bacteremia. In 33 reported cases, co-morbidities were described (2,(4)(5)(6)(7). Contrastingly, our patient was a 36-year-old woman with no known history of underlying chronic disease or immunosuppression.…”

Ralstonia mannitolilytica Bacteremia in an Immunocompromised Patient: Case Report and Review

“…Nonfermenting Gram-negative rods are one of the commonest causes of nosocomial infections in clinical environments. The major opportunistic pathogens in this group are Acinetobacter baumanii; Stenotrophomonas maltophilia and other oxidase-positive bacteria such as Pseudomonas aeruginosa and Burkholderia cepacia [4]. R. mannitolilytica is another emerging opportunistic pathogen which was previously referred as Pseudomonas thomasii and R. pickettii biovar 3/thomasii [4].…”

“…The major opportunistic pathogens in this group are Acinetobacter baumanii; Stenotrophomonas maltophilia and other oxidase-positive bacteria such as Pseudomonas aeruginosa and Burkholderia cepacia [4]. R. mannitolilytica is another emerging opportunistic pathogen which was previously referred as Pseudomonas thomasii and R. pickettii biovar 3/thomasii [4]. It has been reported in nosocomial outbreaks secondary to medical devices, equipment, water, or parenteral solutions contamination [5,6].…”

“…high grade fever, chills and neutrophilic leukocytosis. Majority of the patients were neonates, immunodeficient with frequent hospital visits or indwelling devices [4,5,10,[12][13][14][15][16][17][18][19][20][21][22][23].…”

Outbreak of Ralstonia Mannitolilytica Infection at a Tertiary Care Oncology Center in South India: A Case Series

“…The production of biofilm by RM is incriminated in their ability to cause CLABSI leading to localized and systemic infections which is key to their survival in the environment, evasion of the host's immune response and frequent antibiotic resistance [1]. RM has also been isolated from contaminated oxygen delivery devices [6].…”