ABSTRACT
Resumo O presente relato apresenta o caso de conjuntivite causada por Ralstonia pichettii em paciente imunocompetente usuária de lente de contato. A bactéria isolada da solução utilizada para desinfecção das lentes R. pichettii não pertente a microbiota humana mas infecta pacientes imunodeprimidos e está presente em soluções aquosas. Não há padronização de sensibilidade para esta bactéria e poucos antibióticos foram testados para bactérias não fermentadoras da glicose. Devido ao reduzido perfil de sensibilidade aos antimicrobianos demonstrado pela R. pichettii, torna-se importante a identificação correta deste agente etiológico em quadros de conjuntivite e ceratites. Este relato de caso ilustra que R. Pickettii é um patógeno mais importante do que se pensava anteriormente.
Abstract The present report reports a case of conjunctivitis caused by Ralstonia pichettii in an immunocompetent patient wearing a contact lens. The bacterium isolated from the solution used to disinfect R. pichettii does not belong to the human microbiota but infects immunodepressed patients and is present in aqueous solutions. There is no standardization of sensitivity for this bacterium and few antibiotics have been tested for non-fermenting glucose bacteria. Due to the reduced antimicrobial sensitivity profile demonstrated by R. pichettii, it is important to correctly identify this etiologic agent in conjunctivitis and keratitis. This case report illustrates that R. Pickettii is a more important pathogen than previously thought.
Subject(s)
Humans , Female , Middle Aged , Conjunctivitis, Bacterial/etiology , Gram-Negative Bacterial Infections , Contact Lenses/adverse effects , Ralstonia pickettiiABSTRACT
Ralstonia pickettii is a low-virulence gram-negative bacillus that may be associated with infections related to health care and may cause bacteremia. Ralstonia pickettii bacteremia is uncommon but is related to the contamination of medical products, mainly in immunodepressed patients. We present two cases of patients on chronic hemodialysis with Ralstonia pickettii bacteremia linked to contamination of the dialysis water. Similar cases have been published with links to intravenous fluid administration, medication ampules, and the use of extracorporeal oxygenation membranes, among other factors. The detection of Ralstonia pickettii bacteremia should provoke suspicion and a search for contaminated medical products, fluids, and/or medications.
Subject(s)
Bacteremia/etiology , Dialysis Solutions/standards , Gram-Negative Bacterial Infections/etiology , Ralstonia pickettii/isolation & purification , Renal Dialysis/adverse effects , Aged , Bacteremia/microbiology , Cross Infection/etiology , Cross Infection/microbiology , Gram-Negative Bacterial Infections/microbiology , Humans , Male , Middle AgedABSTRACT
RESUMEN Ralstonia pickettii es un bacilo gram negativo de baja virulencia que puede asociarse a infecciones relacionadas a los cuidados de la salud y provocar bacteriemias. La bacteriemia por Ralstonia pickettii es poco frecuente pero se relaciona con la contaminación de productos de uso médico principalmente en pacientes inmunodeprimidos. Presentamos dos casos en pacientes en hemodiálisis crónica vinculados a contaminación del agua de diálisis. Se han publicado casos similares vinculados a la administración de fluídos intravenosos, ampollas de medicación, asociado a membranas de circulación extracorpórea, entre otros. La detección de una bacteriemia por Ralstonia pickettii, debe sospechar e iniciar la búsqueda de productos de uso médico contaminados, fluídos y/o medicación.
ABSTRACT Ralstonia pickettii is a low-virulence gram-negative bacillus that may be associated with infections related to health care and may cause bacteremia. Ralstonia pickettii bacteremia is uncommon but is related to the contamination of medical products, mainly in immunodepressed patients. We present two cases of patients on chronic hemodialysis with Ralstonia pickettii bacteremia linked to contamination of the dialysis water. Similar cases have been published with links to intravenous fluid administration, medication ampules, and the use of extracorporeal oxygenation membranes, among other factors. The detection of Ralstonia pickettii bacteremia should provoke suspicion and a search for contaminated medical products, fluids, and/or medications.
Subject(s)
Humans , Male , Aged , Dialysis Solutions/standards , Renal Dialysis/adverse effects , Gram-Negative Bacterial Infections/etiology , Bacteremia/etiology , Ralstonia pickettii/isolation & purification , Cross Infection/etiology , Cross Infection/microbiology , Gram-Negative Bacterial Infections/microbiology , Bacteremia/microbiology , Middle AgedSubject(s)
Bacteremia , Ralstonia pickettii , Gram-Negative Bacterial Infections , Humans , Renal DialysisSubject(s)
Bacteremia , Ralstonia pickettii , Gram-Negative Bacterial Infections , Humans , Renal DialysisSubject(s)
Gram-Negative Bacterial Infections/microbiology , Ralstonia pickettii/isolation & purification , Renal Dialysis/adverse effects , Sepsis/microbiology , Aged , Bulgaria , Female , Gram-Negative Bacterial Infections/diagnosis , Gram-Negative Bacterial Infections/drug therapy , Humans , Sepsis/diagnosis , Sepsis/drug therapySubject(s)
Aged , Female , Humans , Gram-Negative Bacterial Infections/microbiology , Ralstonia pickettii/isolation & purification , Renal Dialysis/adverse effects , Sepsis/microbiology , Bulgaria , Gram-Negative Bacterial Infections/diagnosis , Gram-Negative Bacterial Infections/drug therapy , Sepsis/diagnosis , Sepsis/drug therapyABSTRACT
We describe a series of Ralstonia pickettii bloodstream infections (BSI) that occurred in 19 oncohematologic patients admitted to a hospital for patients with cancer, in the city of Rio de Janeiro, from July 1999 to February 2006. Fifty-four R. pickettii isolates were recovered from blood and catheter-tip specimens (1-5 isolates per patient). Two patients eventually died of causes unrelated to R. pickettii BSI. Eight pulsed-field gel electrophoresis genotypes were resolved (A-H), with two detected in more than 1 patient: genotype B, in 2 patients (1.5%), and E, in 12 patients (63.2%). R. pickettii emerged as a new pathogen at our institution, causing at least one outbreak. Cross-transmission of the pathogen, infusion of a putative contaminated intravenous solution, and persistent colonization of medical devices were the likely sources of R. pickettii BSI.