Antimicrobial Treatment on a Catheter-Related Bloodstream Infection (CRBSI) Case Due to Transition of a Multi-Drug-Resistant Ralstonia mannitolilytica from Commensal to Pathogen during Hospitalization

Abstract

Despite its commonly overlooked role as a commensal, Ralstonia mannitolilytica becomes an emerging global opportunistic human pathogen and a causative agent of various infections and diseases. In respiratory illnesses, including cystic fibrosis and chronic obstructive pulmonary disease (COPD), R. mannitolilytica is also identified presumably as colonizer. In this study, one distinctive clone of R. mannitolilytica was firstly identified as colonizer for the first 20 days during hospitalization of a patient. It was then identified as a causative agent for catheter-related bloodstream infection with negative identification after effective treatment, verifying its transition from commensal to pathogen. In conclusion, we provide convincing evidence that during hospitalization of a patient, R. mannitolilytica transitioned from commensal to pathogen in the respiratory tract leading to catheter-related bloodstream infection (CRBSI).

Bloodstream Infections Caused by Drug Resistant Ralstonia species: A Case Series During the COVID-19 Pandemic

“…The prevalence of BSIs by Ralstonia is unknown as the cases are extremely rare, although the infection by the nosocomial pathogen can occur sporadically or in outbreaks particularly in hemodialysis units. 7,8 Rapid and accurate diagnosis is required especially for invasive infections to implement effective therapy. In this case series, four hospitalized patients diagnosed with Ralstonia BSIs are presented from our institution during the COVID-19 pandemic (July 2020-December 2022), along with their clinical outcomes (Table 1).…”

New Insights in Molecular Mechanisms in Antimicrobial Resistance and Strategies in Anti-Biofilms

“…Four manuscripts regarding the prevalence of resistant microbes, the emergence and evolution of resistance, and the molecular investigation of resistance mechanisms have been published in this sub-topic. The first manuscript entitled “Antimicrobial Treatment on a Catheter-Related Bloodstream Infection (CRBSI) Case Due to Transition of a Multi-Drug-Resistant Ralstonia mannitolilytica from Commensal to Pathogen during Hospitalization” provides convincing evidence that R. mannitolilytica transitioned from a commensal to a pathogen in the respiratory tract of a patient during the hospitalization, leading to a CRBSI [ 1 ]. R. mannitolilytica has been widely accepted as a commensal and colonizer; thus, it is easily overlooked.…”