Cupriavidus pauculus Bacteremia in a Child on Extracorporeal Membrane Oxygenation

Abstract

We report a case of bacteremia secondary to Cupriavidus pauculus in a 15-month-old boy on extracorporeal membrane oxygenation (ECMO). The source of the organism was water in the thermoregulator reservoir. The child responded well to cefepime and ciprofloxacin, a delayed oxygenator change out and replacement of the thermoregulator reservoir with a unit that was cleaned and decontaminated with sodium hypochlorite. Isolation of Cupriavidus pauculus from a patient on ECMO support should raise suspicion of the reservoir as a source.

First case of pneumonia caused by Cupriavidus pauculus in an infant in the Gulf Cooperation Council

“…pauculus can cause infections in hospitalized immunocompromised patients, especially in patients with hematologic malignancies, transplants, and AIDS patients. Examples of these infections include bacteremia, peritonitis, abscess, and septicemia caused by C. pauculus [2,9]. The patient in this case was not an exception; he had end-stage renal failure as an underlying disease along with other complications.…”

“…Examples of the source of contamination include nebulization solutions, tap water, hydrotherapy pools, and bottled mineral water [5,8,10]. In addition, medical devices, such as extracorporeal membrane oxygenation (ECMO) equipment and ventilators, have been reported to be a source of contamination [5,9,10]. All environmental samples collected from the patient's room, ventilator, and water sink did not grow any organism in this case, suggesting that no environmental contamination was involved in the respiratory infection process.…”

A Cupriavidus Pauculus Infection in a Patient with a Deep Brain Stimulation Implant

“…Case reports of both community-acquired [6-7] and ventilator-associated pneumonia [8], meningitis, and septicemia [9] have been described, usually in immunocompromised patients. Association with extracorporeal membrane oxygenation (ECMO), which contains a water reservoir, have also been reported as a source of bacteremia [10]. Resistance to meropenem and other antibiotics have been described [11].…”

A Fatal Case of Community Acquired Cupriavidus Pauculus Pneumonia

“…A few reports have described Cupriavidus pauculus infection in children and neonates and several cases have reported positive cultures from intubated Intensive Care Unit (ICU) patients [3,9,11,12].…”

“…Ralstonia paucula, strains have been isolated from various clinical sources including hydrotherapy pools, nebulizers, ultrafiltrated water, thermos-regulator reservoir water extra-corporeal membrane oxygenation system (ECMO), as well as from environmental samples of pool water, groundwater, tap water, soil, and bottled mineral water [5,[8][9][10].…”