Abstract
Ralstonia mannitolilytica is a Gram-negative, nonfermentative, soil bacterium that is reported to cause opportunistic
infections in immunocompromised patients in nosocomial settings. After extensive review
of literature, it was found that this is second outbreak reported from India. This
study is a retrospective analysis of the clinical features, outcome, and source identification
of R. mannitolilytica infection outbreak in a hemato-oncology unit of a tertiary care center of North India
between February 2020 and March 2020. We report an outbreak of R. mannitolilytica bacteremia (with or without septic shock) in five patients admitted in hemato-oncology
unit at a tertiary care institute in North India for 1 month period. Four patients
were cured after administration of appropriate antibiotics as per sensitivity reports,
while one patient died of septicemia due to delayed diagnosis. Environmental cultures
revealed multidose saline bottles used for administration of drugs as the source of
outbreak. Following implementation of use of single dose diluents and flushing solutions
in patients with central venous catheter, no new case was reported. Clinicians and
microbiologists should keep high index of suspicion to identify these organisms as
timely diagnosis is the only key to improve outcomes.
Keywords
Ralstonia - outbreak - hematology - infections - microbiology
