Ralstonia mannitolilytica septicaemia, an added burden in cancer carerecognizing the unrecognized.

Background: Ralstonia mannitolilytica is an often underrecognized pathogen, that can cause infections in immunocompromised hosts. Indwelling catheters are being increasingly used in cancer patients, R. mannitolilytica has a propensity to form biofilms, and this makes it an important pathogen in catheter-related infections. In this study, we report on an outbreak of Ralstonia septicaemia at our facility. Aim: To characterize an outbreak of Ralstonia infections at a tertiary care facility with a focus on antibiotic sensitivity and added burden on treatment. Design: A retrospective analysis of an outbreak of sepsis attributed to R. mannitolilytica. Methods: We report on nine cases of proven R. mannitolilytica septicaemia in the period from January 2022 to June 2023. Results: Blood cultures were positive in 66.7%, and three had tip cultures positive. 77.8% of the patients required removal of their central venous access, due to hemodynamic compromise and/or persistent fever despite adequate coverage with empirical antibiotics. 85.7% required reinsertion of PICC lines. Eight of the isolates (88.9%) were resistant to Meropenem, and seven were resistant to Piperacilin + Tazobactam (77.8%). Resistance to Ceftazidime was seen in six isolates, Sensitivity to Cefaperazone + Sulbactam, and Levolfloxacin was seen in seven and six patients, respectively. [ABSTRACT FROM AUTHOR]