A urokinase-associated outbreak of Ralstonia mannitolilytica bloodstream infections in haemodialysis patients in north-eastern Italy, January to April 2023-Reference-Cited by-同舟云学术

A urokinase-associated outbreak of Ralstonia mannitolilytica bloodstream infections in haemodialysis patients in north-eastern Italy, January to April 2023

Published:2023-07-13 Issue:28 Volume:28 Page:
ISSN:1560-7917
Container-title:Eurosurveillance
language:en
Short-container-title:

Author:

Fabricci Massimiliano¹^ORCID,Trinca Anaïs²^ORCID,Talotti Luca²^ORCID,Busetti Marina³^ORCID,Fotakis Emmanouil Alexandros⁴⁵^ORCID,Merakou Christina⁶⁴^ORCID,Koncan Raffaella²^ORCID,Ghiotti Annachiara⁷,Negri Camilla⁸,Di Maso Vittorio⁹,Bosco Manuela¹⁰,Antonelli Alberto¹¹¹²^ORCID,Coppi Marco¹¹¹²^ORCID,Rossolini Gian Maria¹¹¹²^ORCID,Giuliani Claudia¹³,Scarpis Enrico¹³^ORCID,Gregoretti Barbara¹,Licastro Danilo¹⁴,Luzzati Roberto¹⁵²^ORCID,Costantino Venera³,

Affiliation:

1. Medical Directorate, Trieste University Hospital (ASUGI), Trieste, Italy

2. Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy

3. Microbiology Unit, Trieste University Hospital (ASUGI), Trieste, Italy

4. Italian National Institute of health (ISS), Rome, Italy

5. ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden

6. ECDC fellowship Programme, Public Health Microbiology path (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden

7. Department of Life Sciences, University of Trieste, Trieste, Italy

8. Medical Directorate, Gorizia and Monfalcone Hospital (ASUGI), Gorizia and Monfalcone, Italy

9. Nephrology and Dialysis Unit, Trieste University Hospital (ASUGI), Trieste, Italy

10. Nephrology and Dialysis Unit, Gorizia and Monfalcone Hospital (ASUGI), Gorizia and Monfalcone, Italy

11. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy

12. Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy

13. Medical Directorate, Palmanova Hospital (ASUFC), Palmanova, Italy

14. AREA Science Park, Trieste, Italy

15. Infectious Diseases Unit, Trieste University Hospital (ASUGI), Trieste, Italy

Abstract

An outbreak of Ralstonia mannitolilytica 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 R. mannitolilytica. Whole genome sequences of the clinical and urokinase strains were highly related, and only urokinase-treated patients were reported with R. mannitolilytica infections (attack rate = 34%; 95% confidence interval: 22.1–47.4). Discontinuation of the contaminated urokinase terminated the outbreak.

Publisher

European Centre for Disease Control and Prevention (ECDC)

Subject

Virology,Public Health, Environmental and Occupational Health,Epidemiology

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