Ralstonia mannitolilytica outbreak in a day care oncology ward

Abstract

Aim: Ralstonia mannitolilytica species, an opportunistic pathogen prevalent in moist environmental conditions has been known to cause outbreaks in health care associated institutes. It has been linked to contaminated equipment, antiseptics and other medications. This article deals with an outbreak in Day care ward which caters primarily to oncology patients. Methodology: Blood cultures of febrile patients who had received chemotherapy were evaluated. Environmental surveillance cultures were undertaken to investigate the outbreak. Results: Six patients who presented with fever grew R. mannitolilytica in their blood cultures exhibiting the differential time to positivity. The chemo ports were removed and appropriate antibiotics based on the sensitivity profile were administered. The patients responded to these measures. Environmental surveillance cultures were negative. Conclusion: Accurate identification of nonfermenters in blood cultures is essential for appropriate management of patients. The isolation of organisms such as Ralstonia species could indicate a breach in sterility calling forth appropriate investigations. Infection control training needs to be reinforced regularly to prevent the occurrence of healthcare associated infections.