Outbreak of Ralstonia spp. and Burkholderia spp. Catheter-Related Bloodstream Infection in Hemodialysis Unit

Author:

Valente Mauro1,Orecchioni Francesca2,Brigante Fabiana1,Moretti Maria Ilaria1,Mariani Roberta1,D’Errico Marcello Mario3ORCID,Moretti Marco2,Tavio Marcello4,Ferreiro Cotorruelo Maria Soledad5,Marchi Massimo6,Moglie Emanuele3,Ranghino Andrea17

Affiliation:

1. Nephrology, Dialysis and Renal Transplantation Unit, Azienda Ospedaliero Universitaria delle Marche, 60126 Ancona, Italy

2. Laboratory Medicine, Azienda Ospedaliero Universitaria delle Marche, 60126 Ancona, Italy

3. Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, University Politecnica delle Marche, 60126 Ancona, Italy

4. Unit of Emerging and Immunosuppressed Infectious Diseases, Department of Gastroenterology and Transplantation, Azienda Ospedaliero Universitaria delle Marche, 60126 Ancona, Italy

5. Hospital Medical Advisory Unit, Azienda Ospedaliero Universitaria delle Marche, 60126 Ancona, Italy

6. Fresenius Medical Care Italy S.p.a., 26020 Palazzo Pignano, Italy

7. Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60126 Ancona, Italy

Abstract

The Ralstonia species (RB) and Burkholderia species (BB) are bacteria responsible for nosocomial infections in frail patients such as hemodialyzed (HD) patients. Here, we report how we managed an outbreak caused by RB and BB that occurred in a dialysis unit. From the 7th to the 16th of April 2021, an infection due to RB and BB occurred in 7 out of 39 (17.9%) HD patients with central venous catheter (CVC). Disinfectants, CVC-lock therapy solutions, water by reverse osmosis unit (ROW) and dialysis concentrates were cultured, including the biofilm from the loading plastic tubes (LPTs) that connect the hemodialysis consoles (HCs) to the ROW delivery line. The antibiotic treatment was successful for all patients. RB and BB were isolated in the biofilm of 11/37 LPTs. Three out of 11 positive LPTs were associated with the infected patients. The ROW delivery line was modified to provide a whole disinfection with the HCs connected, avoiding the risk of new contamination of the LPTs. A filtration module of 0.01 mm was added prior to the ROW delivery line. Our experience suggests that outbreaks sustained by unusual bacteria such as RB and BB should be promptly investigated to treat the infected patients with the appropriate therapy and to identify the possible source of infection, making the needful changes to achieve a safer dialysis unit.

Publisher

MDPI AG

Reference25 articles.

1. Cohen, J., Powderly, W., and Opal, S. (2017). Pseudomonas spp., Acinetobacter spp. and miscellaneous Gram-Negative bacilli. Infectious Diseases, Elsevier.

2. Ralstonia mannitolilytica infections in an oncologic day ward: Description of a cluster among high-risk patients;Lucarelli;Antimicrob. Resist. Infect. Control,2017

3. Ralstonia spp.: Emerging global opportunistic pathogens;Ryan;Eur. J. Clin. Microbiol. Infect. Dis.,2014

4. Outbreak of Ralstonia mannitolilytica bacteraemia in patients undergoing haemodialysis at a tertiary hospital in Pretoria, South Africa;Said;Antimicrob. Resist. Infect. Control,2020

5. An Outbreak of Ralstonia pickettii bloodstream infection associated with an intrinsically contaminated normal saline solution;Chen;Infect. Control Hosp. Epidemiol.,2017

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