An outbreak of Ralstonia insidiosa bloodstream infections caused by contaminated heparinized syringes

Tüzemen N. Ü., Önal U., Kazak E., Tezgeç N., Eren H., Şimşek H., ...More

Journal of Infection and Chemotherapy, vol.28, no.10, pp.1387-1392, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 28 Issue: 10
  • Publication Date: 2022
  • Doi Number: 10.1016/j.jiac.2022.06.011
  • Journal Name: Journal of Infection and Chemotherapy
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Page Numbers: pp.1387-1392
  • Keywords: Ralstonia insidiosa, Outbreak, Nosocomial infection, Bloodstream infection, PICKETTII, STERILIZATION
  • Bursa Uludag University Affiliated: Yes


© 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious DiseasesIntroduction: Ralstonia insidiosa, a gram-negative waterborne bacteria able to survive and grow in any type of water source, can cause nosocomial infections, and are considered emerging pathogens of infectious diseases in hospital settings. In this study, we report an outbreak of R. insidiosa at our center related to contaminated heparinized syringes. Material and methods: The present study was conducted in a tertiary care university hospital in Turkey. An outbreak analysis was performed between September 2021 and December 2021. Microbiological samples were obtained from environmental sources and from patient blood cultures. Species identification was performed using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). To investigate the clonality of strains, all confirmed isolates were sent to the National Reference Laboratory and pulsed-field gel electrophoresis (PFGE) was used to perform molecular typing. Results: Seventeen R. insidiosa isolates were identified from the blood cultures of 13 patients from various wards and intensive care units. Isolates from seven patient blood cultures and two heparinized blood gas syringes were characterized by PFGE. All isolates were found to belong to the same clone of R. insidiosa. Conclusion: R. insidiosa was identified as the cause of a nosocomial infection outbreak in our hospital, which was then rapidly controlled by the infection-control team. When rare waterborne microorganisms grow in blood or other body fluid cultures, clinicians and the infection-control team should be made aware of a possible outbreak.