1887
Rapid communication Open Access
Like 0

Abstract

An outbreak of bloodstream infections occurred in four hospitals in north-eastern Italy, involving 20 haemodialysis patients with tunnelled central vascular catheter access. We identified as the outbreak source a batch of urokinase vials imported from India contaminated with Whole genome sequences of the clinical and urokinase strains were highly related, and only urokinase-treated patients were reported with infections (attack rate = 34%; 95% confidence interval: 22.1–47.4). Discontinuation of the contaminated urokinase terminated the outbreak.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2023.28.28.2300328
2023-07-13
2024-05-09
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2023.28.28.2300328
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/28/28/eurosurv-28-28-1.html?itemId=/content/10.2807/1560-7917.ES.2023.28.28.2300328&mimeType=html&fmt=ahah

References

  1. Di Pilato V, Henrici De Angelis L, Aiezza N, Baccani I, Niccolai C, Parisio EM, et al. . Resistome and virulome accretion in an NDM-1-producing ST147 sublineage of Klebsiella pneumoniae associated with an outbreak in Tuscany, Italy: a genotypic and phenotypic characterisation. Lancet Microbe. 2022;3(3):e224-34.  https://doi.org/10.1016/S2666-5247(21)00268-8  PMID: 35544076 
  2. Ryan MP, Adley CC. Ralstonia spp.: emerging global opportunistic pathogens. Eur J Clin Microbiol Infect Dis. 2014;33(3):291-304.  https://doi.org/10.1007/s10096-013-1975-9  PMID: 24057141 
  3. Papagrigorakis E, Vavourakis M, Vlachos C, Zachariou D, Galanis A, Marougklianis V, et al. Osteomyelitis CAUSED by Ralstonia mannitolilytica, a rare opportunistic pathogen. Cureus. 2022;14(4):e24151.  https://doi.org/10.7759/cureus.24151  PMID: 35586345 
  4. Lucarelli C, Di Domenico EG, Toma L, Bracco D, Prignano G, Fortunati M, et al. Ralstonia mannitolilytica infections in an oncologic day ward: description of a cluster among high-risk patients. Antimicrob Resist Infect Control. 2017;6(1):20.  https://doi.org/10.1186/s13756-017-0178-z  PMID: 28191308 
  5. Souza DCD, Palmeiro JK, Maestri AC, Cogo LL, Rauen CH, Graaf ME, et al. Ralstonia mannitolilytica bacteremia in a neonatal intensive care unit. Rev Soc Bras Med Trop. 2018;51(5):709-11.  https://doi.org/10.1590/0037-8682-0118-2018  PMID: 30304284 
  6. Gröbner S, Heeg P, Autenrieth IB, Schulte B. Monoclonal outbreak of catheter-related bacteraemia by Ralstonia mannitolilytica on two haemato-oncology wards. J Infect. 2007;55(6):539-44.  https://doi.org/10.1016/j.jinf.2007.07.021  PMID: 17881058 
  7. Lim CTS, Lee SE. A rare case of Ralstonia mannitolilytica infection in an end stage renal patient on maintenance dialysis during municipal water contamination. Pak J Med Sci. 2017;33(4):1047-9.  https://doi.org/10.12669/pjms.334.13112  PMID: 29067090 
  8. Rajendran UD, Sundaramoorthy S, Sethuraman G. Ralstonia mannitolilytica sepsis in neonatal intensive care unit - Be(a)ware of the multidrug resistant nosocomial bug. Trop Doct. 2022;52(1):216-7.  https://doi.org/10.1177/00494755211036557  PMID: 34374326 
  9. Said M, van Hougenhouck-Tulleken W, Naidoo R, Mbelle N, Ismail F. Outbreak of Ralstonia mannitolilytica bacteraemia in patients undergoing haemodialysis at a tertiary hospital in Pretoria, South Africa. Antimicrob Resist Infect Control. 2020;9(1):117.  https://doi.org/10.1186/s13756-020-00778-7  PMID: 32727576 
  10. Aranas DR, Demot BA, Cajulao TPT. Outbreak of Ralstonia bacteraemia among chronic kidney disease patients in a haemodialysis unit in the Philippines. Western Pac Surveill Response J. 2022;13(4):1-6.  https://doi.org/10.5365/wpsar.2022.13.4.960  PMID: 36817499 
  11. Chen YY, Huang WT, Chen CP, Sun SM, Kuo FM, Chan YJ, et al. An outbreak of Ralstonia pickettii bloodstream infection associated with an intrinsically contaminated normal saline solution. Infect Control Hosp Epidemiol. 2017;38(4):444-8.  https://doi.org/10.1017/ice.2016.327  PMID: 28115025 
  12. Kimura AC, Calvet H, Higa JI, Pitt H, Frank C, Padilla G, et al. Outbreak of Ralstonia pickettii bacteremia in a neonatal intensive care unit. Pediatr Infect Dis J. 2005;24(12):1099-103.  https://doi.org/10.1097/01.inf.0000190059.54356.f3  PMID: 16371873 
  13. Raveh D, Simhon A, Gimmon Z, Sacks T, Shapiro M. Infections caused by Pseudomonas pickettii in association with permanent indwelling intravenous devices: four cases and a review. Clin Infect Dis. 1993;17(5):877-80.  https://doi.org/10.1093/clinids/17.5.877  PMID: 8286629 
  14. Donlan RM. Biofilms and device-associated infections. Emerg Infect Dis. 2001;7(2):277-81.  https://doi.org/10.3201/eid0702.010226  PMID: 11294723 
  15. European Centre for Disease Prevention and Control (ECDC). Communicable Disease Threats Report. Week 27, 1-8 July 2023. Stockholm: ECDC; 2023. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/communicable-disease-threats-report-week-27-2023.pdf
/content/10.2807/1560-7917.ES.2023.28.28.2300328
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error