Rare Cases of Ralstonia pickettii Associated with Tonsillitis and Wound Infection
AbstractBackground: We describe here two rare case of Ralstonia pickettii infection associated with tonsillitis and wound infection. Ralstonia pickettii is a gram negative bacteria, usually isolated from the soil and water. Infection-associated Ralstonia species though rare, has become an emerging nosocomial pathogen due to its capability to survive in harsh conditions like antiseptic solutions. Both of our reported cases presented to the outdoor patient unit and thus possibility of community acquired Ralstonia picketti infection cannot be ruled out. Methods: Isolates were subjected to Siemens MicroScan WalkAway 96 Plus (Beckman Caulter Diagnostics, USA) for identification and antimicrobial susceptibility testing. Results: Ralstonia pickettii was identified as a rarely detected pathogen. Conclusion: Ralstonia pickettii though rarely associated with wound infections and tonsillitis, could be a potential hospital acquired pathogen.
Ryan MP, Adley CC. The antibiotic susceptibility of water-based bacteria Ralstonia pickettii and Ralstonia insidiosa. J. Med. Microbiol. 2013; 62:1025-1031
Verschraegen G, Claeys G, Meeus G, Delanghe M. Pseudomonas pickettii as a cause of pseudobacteremia. J Clin Micrbiol. 1985; 21(2):278-279
Barbut F, Kosmann MJ, Lalande V, Neyme D, Coppo P, et.al. Outbreak of Ralstonia pickettii pseudobacteremia among patients with hematological malignancies. Infect. Control Hospital Epidemiol. 2006; 27(6):642-644
Edwards BD, Somayaji R, Missaghi B, Chan WW, Bois AJ. Prosthetic joint and implant contamination caused by Ralstonia picketti: a report of three cases. SICOT J. 2017; 3:32
Lim CTS, Lee SE. A rare case of Ralstonia mannitolilytica infection in an end stage renal patient on maintenance dialysis during municipal water contamination. Pak. J. Med. Sci. 2017; 33(4): 1047-1049
Coman I., Bilodeau L., Lavoie A., Carricart M., Tremblay F., Zlosnik J.E., Berthiaume Y. Ralstonia mannitolilytica in cystic fibrosis: A new predictor of worse outcomes. Respir. Med. Case Rep. 2017;20:48–50.
Ryan MP, Adley CC. Ralstonia spp.: emerging global opportunistic pathogens. Eur. J. Clin. Microbiol. Infect. 2014; 33:291-304
Stelzmueller I, Biebl M, Wiesmayr S, Eller M, Hoeller E, et.al. Ralstonia pickettii- innocent bystander or a potential threat? Clin. Microbiol. Infect. 2006; 12(2):99-101