1
|
Bilodeau KS, Charette K, McMullan DM. Safety and Efficacy of Extracorporeal Membrane Oxygenation Heating Units. World J Pediatr Congenit Heart Surg 2024; 15:30-35. [PMID: 37915224 DOI: 10.1177/21501351231185114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
BACKGROUND Patient temperature during extracorporeal membrane oxygenation (ECMO) is commonly managed by dedicated heating units (HUs) that are integrated into ECMO circuitry. Currently, no HU has received approval for ECMO by the FDA in the United States. Older FDA-approved HUs have been implicated in life-threatening patient infections and are no longer manufactured or available for use in the United States. METHODS We performed laboratory tests to evaluate the safety and efficacy of the Micro-Temp and the HTP-1500 HU systems that are potentially suitable for use in ECMO and describe our initial experience with the HTP-1500 HU after being placed in clinical service. RESULTS Both units demonstrated similar heating efficacy, with the HTP-1500 achieving steady-state temperature approximately 5 h earlier than the Micro-Temp. Microorganisms were detected in the water compartment of all HUs prior to and after performing the manufacturer's recommended cleaning procedure, and after implementation of the HTP-1500 into clinical use we observed a decrease in the rate of bloodstream infection/ECMO days which did not reach statistical significance. CONCLUSION Based on the results of this analysis and our institutional experience, we believe that integration of the HTP-1500 HU, an easily replaceable HU, into ECMO systems may reduce the risk of bacterial contamination and thus nosocomial infection when the devices are cleaned and maintained according to manufacturer's guidelines.
Collapse
Affiliation(s)
- Kyle S Bilodeau
- Division of Cardiac Surgery, Seattle Children's Hospital, Seattle, WA, USA
| | - Kevin Charette
- Division of Perfusion, Seattle Children's Hospital, Seattle, WA, USA
| | - D Michael McMullan
- Division of Cardiac Surgery, Seattle Children's Hospital, Seattle, WA, USA
| |
Collapse
|
2
|
Menekşe Ş, Tanrıverdi ES, Oğuş H, Altınay E, Kaya Ç, Çağlayan E, Aydoğan AA, Otlu B, Kırali MK. Stenotrophomonas maltophilia outbreak with a commercial blood gas injector as the culprit and interventions for source and prevention: a possible passage between patient and ECMO water heater device. Am J Infect Control 2022; 51:533-538. [PMID: 35868456 DOI: 10.1016/j.ajic.2022.07.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/02/2022] [Accepted: 07/06/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Despite low virulence of Stenotrophomonas maltophilia, it represents one of the leading drug-resistant bacteria. We report a large outbreak of S. maltophilia infection associated with an unexpected source, which turned out to be a commercial needleless blood gas injector. METHODS Over a period from 1th January to 10th December, 2021, 113 patients were identified to have S. maltophilia infection as documented by positive cultures from the clinical samples, extracorporeal membrane oxygenation (ECMO) water heater devices and commercial needleless blood gas injectors. RESULTS Sixty-seven isolates (59 clinical, 4 ECMO, 4 blood gas injectors) were sent for molecular analysis. Both AP-PCR and PFGE analyses showed 12 distinct genotypes. Of 67 isolates, 58 were clonally related (86.6%), with 52 indistinguishable strains from four blood gas needleless injectors, 46 patients' samples (78%) and 2 ECMO samples (50%). Two ECMO samples and one clinical sample were clonally identical. CONCLUSION In the event that eradication of infections would not be possible despite taking all environmental disinfection measures including the ECMO devices, unexpected sources, such as a commercial needleless blood gas injector, should not be omitted from the list for surveillance. In addition, obtaining surveillance cultures of ECMO water reservoirs should be placed in the routine clinical practice.
Collapse
Affiliation(s)
- Şirin Menekşe
- Infection Control Unit, Koşuyolu High Specialization Education and Research Hospital, İstanbul, Turkey.
| | - Elif Seren Tanrıverdi
- Department of Medical Microbiology, Molecular Microbiology Laboratory, İnonu University Faculty of Medicine, Turgut Özal Medical Centre, Malatya, Turkey
| | - Halide Oğuş
- Department of Anesthesia, Koşuyolu High Specialization Education and Research Hospital, İstanbul, Turkey
| | - Ece Altınay
- Department of Anesthesia, Koşuyolu High Specialization Education and Research Hospital, İstanbul, Turkey
| | - Çiğdem Kaya
- Infection Control Unit, Koşuyolu High Specialization Education and Research Hospital, İstanbul, Turkey
| | - Elif Çağlayan
- Department of Medical Microbiology, Koşuyolu High Specialization Education and Research Hospital, İstanbul, Turkey
| | - Arzu Ateşoğlu Aydoğan
- Infection Control Unit, Koşuyolu High Specialization Education and Research Hospital, İstanbul, Turkey
| | - Barış Otlu
- Department of Medical Microbiology, Molecular Microbiology Laboratory, İnonu University Faculty of Medicine, Turgut Özal Medical Centre, Malatya, Turkey
| | - Mehmet Kaan Kırali
- Department of Cardiovascular Surgery, Koşuyolu High Specialization Education and Research Hospital, İstanbul, Turkey
| |
Collapse
|
3
|
Baker MA, Rhee C, Tucker R, Vaidya V, Holtzman M, Seethala RR, Bentain-Melanson M, Lenox J, Smith AR, Gassett A, Huntley M, Sater M, Reilly K, Klompas M. Ralstonia pickettii and Pseudomonas aeruginosa Bloodstream Infections Associated with Contaminated Extracorporeal Membrane Oxygenation Water Heater Devices. Clin Infect Dis 2022; 75:1838-1840. [PMID: 35594555 DOI: 10.1093/cid/ciac379] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Indexed: 11/13/2022] Open
Abstract
We report on probable factory-based contamination of portable water heaters with waterborne pathogens and two bloodstream infections potentially attributable to off-label use of these water heaters to warm extracorporeal membrane oxygenation circuits. Great caution is warranted when using water-based devices to care for critically ill patients.
Collapse
Affiliation(s)
- Meghan A Baker
- Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA, USA.,Brigham and Women's Hospital, Boston, MA, USA.,Infection Control Department, Dana Farber Cancer Institute, Boston, MA, USA
| | - Chanu Rhee
- Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA, USA.,Brigham and Women's Hospital, Boston, MA, USA
| | | | | | | | | | | | | | | | | | | | | | | | - Michael Klompas
- Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA, USA.,Brigham and Women's Hospital, Boston, MA, USA
| |
Collapse
|
4
|
Rhee C, Baker MA, Tucker R, Vaidya V, Holtzman M, Seethala RR, Bentain-Melanson M, Lenox J, Smith AR, Boyer JC, Gassett A, Brigl M, Sater M, Huntley M, Woolley AE, Goldberg HJ, Reilly K, Resnick A, Pearson M, Klompas M. Cluster of Burkholderia cepacia Complex Infections Associated with Extracorporeal Membrane Oxygenation Water Heater Devices. Clin Infect Dis 2022; 75:1610-1617. [PMID: 35271726 DOI: 10.1093/cid/ciac200] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Burkholderia cepacia complex is a group of potential nosocomial pathogens often linked to contaminated water. We report on a cluster of 8 B.cepacia complex infections in cardiothoracic ICU patients attributed to contaminated ECMO water heaters. METHODS In December 2020, we identified an increase in B.cepacia complex infections in the cardiothoracic ICU at Brigham and Women's Hospital. We sought commonalities, sequenced isolates, obtained environmental specimens, and enacted mitigation measures. RESULTS Whole genome sequencing of 13 B.cepacia complex clinical specimens between November 2020-February 2021 identified 6 clonally related isolates, speciated as Burkholderia contaminans. All 6 occurred in patients on ECMO. Microbiology review identified two additional B.contaminans cases from June 2020, including one ECMO patient, that may have been cluster-related as well. All 8 definite/probable cluster cases required treatment; 3 died and 3 developed recurrent infections. After ECMO was identified as the major commonality, all 9 of the hospital's ECMO water heaters were cultured; all grew B.contaminans. Air sampling adjacent to the water heaters was culture-negative. Water heater touch screens were culture-positive for B.contaminans. The sink drain in the ECMO heater reprocessing room also grew clonal B.contaminans. Observations of reprocessing revealed opportunities for cross-contamination between devices via splash from the contaminated sink. The cluster was aborted by removing all water heaters from clinical service. CONCLUSIONS We identified a cluster of 8 B.cepacia complex infections associated with contaminated ECMO water heaters. This cluster underscores the potential risks associated with water-based ECMO heaters and, more broadly, water-based care for vulnerable patients.
Collapse
Affiliation(s)
- Chanu Rhee
- Brigham and Women's Hospital, Boston, MA, USA.,Department of Population Medicine, Harvard Medical School / Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Meghan A Baker
- Brigham and Women's Hospital, Boston, MA, USA.,Department of Population Medicine, Harvard Medical School / Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | | | | | | | | | | | | | | | - Jon C Boyer
- Brigham and Women's Hospital, Boston, MA, USA
| | | | | | | | | | | | | | | | | | | | - Michael Klompas
- Brigham and Women's Hospital, Boston, MA, USA.,Department of Population Medicine, Harvard Medical School / Harvard Pilgrim Health Care Institute, Boston, MA, USA
| |
Collapse
|
5
|
Lampropoulos P, Gkentzi D, Tzifas S, Kapnisi G, Karatza A, Kolonitsiou F, Dimitriou G. Ralstonia Mannitolilytica, an Unusual Pathogen in the Neonatal Intensive Care Unit: A Case of Neonatal Sepsis and Literature Review. Infect Disord Drug Targets 2021; 21:168-172. [PMID: 32223739 DOI: 10.2174/1871526520666200330163504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Premature infants are considered high-risk subgroup for neonatal sepsis due to yet defective immune system, interventions practised and synergy of factors favoring multiple resistance of Gram-positive and Gram-negative pathogens to antimicrobial agents. CASE PRESENTATION We present a case of late-onset neonatal sepsis in a premature infant caused by an uncommon pathogen; a premature infant of extremely low birth weight had in his 4th week of life severe clinical deterioration with lethargy, fever, pallor, mottling, abdominal distention, tachycardia, and worsening respiratory impairment. Full septic screen was performed, broad-spectrum antibiotic therapy was initiated and supportive care per needs was provided. Blood cultures (endotracheal tube tip cultures) isolated meropenem- and gentamicin-resistant strain of rare pathogen Ralstonia mannitolilytica. Ralstonia spp. are aerobic, Gram-negative, lactose non-fermenting, oxidaseand catalase-positive bacilli, thriving in water and soil. Ralstonia spp. are identified only sporadically as causative agents of neonatal sepsis; to our knowledge, this is the second report of neonatal sepsis due to R. mannitolilytica in the literature so far. Our patient was eventually treated (per sensitivity pattern) with intravenous ciprofloxacin and recovered well from the infection. CONCLUSION We intend to raise awareness among neonatologists with regard to early detection of unusual pathogens, the emergence of antibiotic resistance patterns, and the obligation for adherence to infection control policies.
Collapse
Affiliation(s)
- Panagiotis Lampropoulos
- Department of Pediatrics and Neonatology, University General Hospital of Patras, Patras, Greece
| | - Despoina Gkentzi
- Department of Pediatrics and Neonatology, University General Hospital of Patras, Patras, Greece
| | - Sotirios Tzifas
- Department of Pediatrics and Neonatology, University General Hospital of Patras, Patras, Greece
| | - Georgia Kapnisi
- Department of Microbiology, University General Hospital of Patras, Patras, Greece
| | - Ageliki Karatza
- Department of Pediatrics and Neonatology, University General Hospital of Patras, Patras, Greece
| | - Fevronia Kolonitsiou
- Department of Microbiology, University General Hospital of Patras, Patras, Greece
| | - Gabriel Dimitriou
- Department of Pediatrics and Neonatology, University General Hospital of Patras, Patras, Greece
| |
Collapse
|
6
|
Nosocomial Infections During Extracorporeal Membrane Oxygenation in Neonatal, Pediatric, and Adult Patients: A Comprehensive Narrative Review. Pediatr Crit Care Med 2020; 21:283-290. [PMID: 31688809 DOI: 10.1097/pcc.0000000000002190] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Extracorporeal membrane oxygenation is increasingly used in critically ill patients with refractory cardiopulmonary failure. Nosocomial infection acquired during extracorporeal membrane oxygenation represents one of the most frequent complications but the available evidence on the risk of infection and its association with outcomes has not been comprehensively analyzed. We performed a narrative review examining the epidemiology of nosocomial infection during extracorporeal membrane oxygenation, association with clinical outcomes, and preventive strategies. DATA SOURCES We searched PubMed, Web of Science, EMBASE, and the Cochrane Library between 1972 and June 2018. STUDY SELECTION We included any article which detailed nosocomial infection during extracorporeal membrane oxygenation. Articles were excluded if they were not written in English, detailed extracorporeal membrane oxygenation use for infections acquired prior to extracorporeal membrane oxygenation, or used other forms of extracorporeal support such as ventricular assist devices. DATA EXTRACTION Two reviewers independently assessed eligibility and extracted data. We screened 984 abstracts and included 59 articles in the final review. DATA SYNTHESIS The reported risk of nosocomial infection among patients receiving extracorporeal membrane oxygenation ranged from 3.5% to 64% per extracorporeal membrane oxygenation run, while the incidence of infection ranged from 10.1 to 116.2/1,000 extracorporeal membrane oxygenation days. Nosocomial infections during extracorporeal membrane oxygenation were consistently associated with longer duration of extracorporeal membrane oxygenation and, in several large multicenter studies, with increased mortality. Risk factors for nosocomial infection included duration of extracorporeal membrane oxygenation, mechanical and hemorrhagic complications on extracorporeal membrane oxygenation, and use of venoarterial and central extracorporeal membrane oxygenation. Biomarkers had low specificity for infection in this population. Few studies examined strategies on how to prevent nosocomial infection on extracorporeal membrane oxygenation. CONCLUSIONS Nosocomial infections in extracorporeal membrane oxygenation patients are common and associated with worse outcomes. There is substantial variation in the rates of reported infection, and thus, it is possible that some may be preventable. The evidence for current diagnostic, preventive, and therapeutic strategies for infection during extracorporeal membrane oxygenation is limited and requires further investigation.
Collapse
|
7
|
Basso M, Venditti C, Raponi G, Navazio AS, Alessandri F, Giombini E, Nisii C, Di Caro A, Venditti M. A case of persistent bacteraemia by Ralstonia mannitolilytica and Ralstonia pickettii in an intensive care unit. Infect Drug Resist 2019; 12:2391-2395. [PMID: 31447567 PMCID: PMC6686741 DOI: 10.2147/idr.s206492] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 06/12/2019] [Indexed: 12/12/2022] Open
Abstract
The Ralstonia spp. genus is a group of non-fermentative, Gram-negative bacteria often resistant to many antibiotics, which are emerging as opportunistic pathogens frequently associated with infections in hospital settings. We present herein a case of combined R. pickettii and R. mannitolilytica persisting and relapsing bacteraemia, possibly caused by a septic arterial thrombosis secondary to the rupture of an internal carotid artery aneurysm. Microbiology studies showed that both Ralstonia isolates produced biofilm and carried class D oxacillinase genes. When confronted with infections caused by members of the Ralstonia genus, identification to the species level is crucial for correct clinical management, as the two species show different antibiotic susceptibility patterns.
Collapse
Affiliation(s)
- Monica Basso
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Carolina Venditti
- Laboratory of Microbiology, L. Spallanzani National Institute for Infectious Diseases, Rome, Italy
| | - Giammarco Raponi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome Italy
| | - Anna Sara Navazio
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome Italy
| | - Francesco Alessandri
- Department of Anesthesia and Intensive Care Medicine, Sapienza University of Rome, Rome, Italy
| | - Emanuela Giombini
- Laboratory of Microbiology, L. Spallanzani National Institute for Infectious Diseases, Rome, Italy
| | - Carla Nisii
- Laboratory of Microbiology, L. Spallanzani National Institute for Infectious Diseases, Rome, Italy
| | - Antonino Di Caro
- Laboratory of Microbiology, L. Spallanzani National Institute for Infectious Diseases, Rome, Italy
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome Italy
| |
Collapse
|
8
|
Nasir N, Sayeed MA, Jamil B. Ralstonia pickettii Bacteremia: An Emerging Infection in a Tertiary Care Hospital Setting. Cureus 2019; 11:e5084. [PMID: 31516793 PMCID: PMC6721917 DOI: 10.7759/cureus.5084] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Ralstonia species are Gram-negative bacilli that have increasingly been recognized as emerging nosocomial pathogens, particularly in immunocompromised hosts. Ralstonia pickettii is the most clinically important pathogen from the Ralstonia genus. Nosocomial outbreaks of Ralstonia pickettii infections brought about by the use of contaminated medical solutions, including saline, sterile water, as well as disinfectants, have been reported. There have been case reports of invasive infections with variable presentations. Here, we describe three cases of Ralstonia pickettii bacteremia during a period of one year in a tertiary care hospital in Karachi, Pakistan. The first case was a 76-year-old male, known case of type 2 diabetes mellitus (DM), hypertension, and amyotrophic lateral sclerosis, who presented with complaints of burning micturition, hematuria, and fever. The patient had a history of multiple hospital admissions in the recent past. His blood culture was found to be positive for Ralstonia pickettii. A computed tomography scan of the kidneys, ureter, and bladder (CT KUB) was suggestive of pyelonephritis. The patient improved on intravenous meropenem. The second case was a 47-year-old man, who was admitted with a gunshot injury to the neck, resulting in complete cervical cord resection and mild hydrocephalus with intraventricular hemorrhage. The patient had a prolonged intensive care unit (ICU) stay, which was complicated by ventilator-associated pneumonia with Acinetobacter and central line-associated bloodstream infection (CLABSI) with Ralstonia pickettii. He was treated with meropenem and colistin but continued to deteriorate and expired. The third case was a 46-year-old lady, known case of end-stage renal disease (ESRD), who was admitted with prosthetic valve endocarditis. She had a prolonged hospital stay complicated by CLABSI with Ralstonia pickettii, improved on meropenem, but later died due to fungemia. Ralstonia pickettii is an emerging cause of nosocomial infection in patients, particularly those with a prolonged hospital stay, and can cause invasive and severe infections.
Collapse
Affiliation(s)
- Nosheen Nasir
- Internal Medicine, Aga Khan University Hospital, Karachi, PAK
| | | | - Bushra Jamil
- Internal Medicine, Aga Khan University Hospital, Karachi, PAK
| |
Collapse
|
9
|
Tejera D, Limongi G, Bertullo M, Cancela M. Ralstonia pickettii bacteremia in hemodialysis patients: a report of two cases. Rev Bras Ter Intensiva 2017; 28:195-8. [PMID: 27410414 PMCID: PMC4943058 DOI: 10.5935/0103-507x.20160033] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 02/22/2016] [Indexed: 12/23/2022] Open
Abstract
Ralstonia pickettii is a low-virulence gram-negative bacillus
that may be associated with infections related to health care and may cause
bacteremia. Ralstonia pickettii bacteremia is uncommon but is
related to the contamination of medical products, mainly in immunodepressed
patients. We present two cases of patients on chronic hemodialysis with
Ralstonia pickettii bacteremia linked to contamination of
the dialysis water. Similar cases have been published with links to intravenous
fluid administration, medication ampules, and the use of extracorporeal
oxygenation membranes, among other factors. The detection of Ralstonia
pickettii bacteremia should provoke suspicion and a search for
contaminated medical products, fluids, and/or medications.
Collapse
|
10
|
Sharma D, Sharma P, Soni P, Gupta B. Ralstonia picketti neonatal sepsis: a case report. BMC Res Notes 2017; 10:28. [PMID: 28061799 PMCID: PMC5219797 DOI: 10.1186/s13104-016-2347-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 12/16/2016] [Indexed: 11/10/2022] Open
Abstract
Background Ralstonia genus are gram negative bacillus and includes four bacteria namely Ralstonia picketti, Ralstonia Solanacearum, Ralstonia insidiosa and Ralstonia mannitolilytica. These are opportunistic pathogens and cause infections in immunocompromised host. The sources of infection are usually contaminated solutions and water. The majority of the reported cases are caused by R. picketti. It is very rare cause of neonatal sepsis with less than twenty cases reported in literature till date. Case presentation A late preterm male infant, Indian race was admitted to the neonatal intensive care unit for respiratory distress developing soon after birth. The infant was managed with respiratory support and gradually infant improved and diagnosis of transient tachypnea of newborn was made. At age of 84 h of postnatal life, the infant developed features of neonatal sepsis and investigations were suggestive of sepsis. The infant was started on intravenous antibiotic, multiple vasopressors and steroids. The blood culture showed growth of multi-drug resistant R. picketti. The antibiotics were changed as per sensitivity pattern and infant was discharged in good condition and was accepting breast feeding at the time of discharge. There was also no other case of R. picketti in the nursery during the same time period. Conclusion Ralstonia picketti is an uncommon cause of neonatal sepsis and usually source of infection are contaminated solutions and medical products. The management involves early detection, treatment with appropriate antibiotics and doing surveillance culture to identify the possible source of infection.
Collapse
Affiliation(s)
- Deepak Sharma
- NEOCLINIC, TN Mishra Marg, Everest Vihar, Nirman Nagar, Jaipur, Rajasthan, India.
| | - Pradeep Sharma
- Department of Medicine, Mahatma Gandhi Medical College, Jaipur, Rajasthan, India
| | - Priyanka Soni
- Department of Microbiology, J.L.N Medical College, Ajmer, Rajasthan, India
| | - Basudev Gupta
- Department of Pediatrics, Civil Hospital, Palwal, Haryana, India
| |
Collapse
|
11
|
|
12
|
Native Valve Endocarditis due to Ralstonia pickettii: A Case Report and Literature Review. Case Rep Infect Dis 2015; 2015:324675. [PMID: 25648998 PMCID: PMC4306225 DOI: 10.1155/2015/324675] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 11/10/2014] [Accepted: 12/17/2014] [Indexed: 11/17/2022] Open
Abstract
Ralstonia pickettii is a rare pathogen and even more rare in healthy individuals. Here we report a case of R. pickettii bacteremia leading to aortic valve abscess and complete heart block. To our knowledge this is the first case report of Ralstonia species causing infective endocarditis with perivalvular abscess.
Collapse
|
13
|
Ryan MP, Adley CC. Ralstonia spp.: emerging global opportunistic pathogens. Eur J Clin Microbiol Infect Dis 2013; 33:291-304. [DOI: 10.1007/s10096-013-1975-9] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 09/01/2013] [Indexed: 11/28/2022]
|
14
|
Nosocomial Transmission of Cupriavidus pauculus During Extracorporeal Membrane Oxygenation. ASAIO J 2010; 56:486-7. [DOI: 10.1097/mat.0b013e3181f0c80d] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
15
|
|