A Case of Ralstonia pickettii Bloodstream Infection and the Growing Problem of Healthcare Associated Infections in Frail Older Adults

Abstract

Frailty is a clinically measurable state of vulnerability to developing increased dependency and/or mortality when exposed to a stressor. Chronic diseases, aggressive treatments, antibiotic overuse, microbiota changes, immune senescence, and increased use of medical devices and implants (i.e., central lines and catheters) expose modern patients to healthcare-associated infections (HAIs), multidrug-resistant bacteria, and new and unusual opportunistic pathogens. Older adults are among the main victims of HAIs and are associated with high costs, disability, morbidity, and mortality.Ralstonia pickettii is an emerging opportunistic pathogen that causes rare nosocomial infections in frail individuals. Herein, we present a case of bloodstream infection caused by R. pickettii in an 88year-old woman with a relatively mild course. In addition to describing this unusual finding, this report discusses the problem of HAIs in older adults. Older age, comorbidities, and hospital admissions were among the main risk factors for HAIs. Adherence to guidelines, training, auditing, and surveillance is crucial for reducing the burden of HAIs in acute settings. Furthermore, avoiding incongruous hospitalizations would have positive implications both for preventing HAIs and improving patient quality of life.

Persistent bacteremia caused by Ralstonia pickettii and Microbacterium: a case report

“…The infection event of the patient is the most likely during the operation. Indeed, there have been reports that Ralstonia bacteria can survive in liquid media and in hospital settings and devices [ 25 ], as an opportunistic pathogen. Since the intraoperative pathology was not tested for bacterial culture, the operating room environment and instrument culture were negative.…”

Rapidly Progressive Malignant Pelvic Perivascular Epithelioid Cell Neoplasm (PEComa) Associated with Eggerthella lenta Bloodstream Infection

“…The complexity of modern patients introduces new and significant players in host-microbe interactions, and emerging pathogens represent a relevant challenge in modern healthcare. 2 ) Among these pathogens is Eggerthella lenta , an anaerobic gram-positive bacterium of the normal gut microbiota associated with life-threatening infections. 3 , 4 )…”