Outbreak of Ralstonia bacteraemia among chronic kidney disease patients in a haemodialysis unit in the Philippines.

IF 1 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Denmarc R Aranas, Bernard A Demot, Thea Pamela T Cajulao
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引用次数: 2

Abstract

Ralstonia insidiosa is an opportunistic pathogen considered an emerging problem among clinically vulnerable populations such as those with chronic kidney disease. This study presents three cases of Ralstonia bacteraemia among chronic kidney disease patients in a haemodialysis unit in Baguio City, the Philippines. Case 1 was an elderly male who experienced chills during two concurrent dialysis sessions. Case 2 was a young female who also experienced chills and dizziness during a dialysis session; as this was thought to be related to hypotension, she was admitted. Case 3 was an elderly female with known hypertension and diabetes who had been newly diagnosed with chronic kidney disease; she was brought to the emergency department hypotensive, dyspnoeic and disoriented with deranged laboratory parameters and was admitted to the intensive care unit. All three cases had blood cultures positive for R. insidiosa with an attack rate of 1.67%. Drug and device tracing were conducted and environmental samples collected to identify the source of infection. A sample from the faucet of the reprocessing machine in the haemodialysis unit that was positive for Ralstonia spp. was the source of the outbreak. Control measures were implemented and the haemodialysis unit was thoroughly cleaned. No further cases were reported, with active surveillance continuing until January 2022. Taken with previously published outbreaks, these findings suggest that medical products and devices can be contaminated with Ralstonia spp. and cause illness. Early identification of cases and the source of infection is required to prevent large outbreaks in this vulnerable population.

在菲律宾的一个血液透析单位慢性肾脏病患者爆发拉尔斯顿菌血症。
裂谷杆菌是一种机会性病原体,被认为是临床易感人群(如慢性肾病患者)中新出现的问题。本研究提出了三例拉尔斯顿菌菌血症慢性肾病患者在碧瑶市血液透析单位,菲律宾。病例1是一位老年男性,他在两次同步透析期间经历了寒战。病例2是一名年轻女性,她在透析期间也经历了寒战和头晕;由于这被认为与低血压有关,她住院了。病例3为已知高血压和糖尿病的老年女性,新诊断为慢性肾病;她被送到急诊科低血压、呼吸困难、定向障碍、实验室参数紊乱,并被送入重症监护室。3例血培养均阳性,发病率为1.67%。进行了药物和器械追踪并收集了环境样本以确定感染源。从血液透析室的再处理机器的水龙头中采集的样本对拉尔斯顿菌呈阳性反应,这是此次疫情的源头。实施控制措施,彻底清洁血液透析室。未报告进一步病例,积极监测将持续到2022年1月。结合先前公布的疫情,这些发现表明医疗产品和设备可能被拉尔斯顿菌污染并导致疾病。需要及早发现病例和感染源,以防止在这一脆弱人群中发生大规模疫情。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Western Pacific Surveillance and Response
Western Pacific Surveillance and Response PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
1.70
自引率
0.00%
发文量
23
审稿时长
15 weeks
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