Ralstonia mannitolilytica is a gram negative soil bacterium. Ralstonia infection though rare, has become the emerging nosocomial pathogens in hospital settings. Various clinical manifestations had been described as well as the mode of transmission. Despite its low virulence factor, it is able to survive under harsh condition and this may potentially cause significant morbidity and mortality especially in immunocompromised patients. Outbreak of Ralstonia mannitolilytica infections in the hospital are typically associated with contaminated medical supplies or instruments. We described here a case of Ralstonia mannitolilytica infection in a dialysis patient that occurred during the municipal reservoir water contamination crisis. In this report, we will also describe the behaviour of Ralstonia genus and its 4 main species, namely R. pickettii, R. solanacearum, R. insidiosa, and R. mannitolilytica and the choices of antibiotic therapy based on literature review.

Dengue is a viral infection transmitted by an Aedes aegypti mosquito bite that poses a major threat to public health worldwide. While acute kidney injury secondary to dengue infection is a potentially lethal complication, it remains one of the least studied complications of dengue fever. The underlying mechanism of dengue-associated acute kidney injury is complex because it involves multiple pathways that could independently lead to its occurrence. Therefore, the cornerstone of dengue-associated acute kidney injury management should involve prompt recognition and identification of the at-risk population and administration of appropriate supportive treatment in a timely manner with the aim of preventing both renal and non-renal morbidity and mortality.