Open AccessBrief Report
Outbreak of Ralstonia spp. and Burkholderia spp. Catheter-Related Bloodstream Infection in Hemodialysis Unit
by
Mauro Valente, Francesca Orecchioni, Fabiana Brigante, Maria Ilaria Moretti, Roberta Mariani, Marcello Mario D’Errico, Marco Moretti, Marcello Tavio, Maria Soledad Ferreiro Cotorruelo, Massimo Marchi, Emanuele Moglie and Andrea Ranghino
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Abstract
The
Ralstonia species (
RB) and
Burkholderia species (
BB) are bacteria responsible for nosocomial infections in frail patients such as hemodialyzed (HD) patients. Here, we report how we managed an outbreak caused by
RB and
BB that occurred in a
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The
Ralstonia species (
RB) and
Burkholderia species (
BB) are bacteria responsible for nosocomial infections in frail patients such as hemodialyzed (HD) patients. Here, we report how we managed an outbreak caused by
RB and
BB that occurred in a dialysis unit. From the 7th to the 16th of April 2021, an infection due to
RB and
BB occurred in 7 out of 39 (17.9%) HD patients with central venous catheter (CVC). Disinfectants, CVC-lock therapy solutions, water by reverse osmosis unit (ROW) and dialysis concentrates were cultured, including the biofilm from the loading plastic tubes (LPTs) that connect the hemodialysis consoles (HCs) to the ROW delivery line. The antibiotic treatment was successful for all patients.
RB and
BB were isolated in the biofilm of 11/37 LPTs. Three out of 11 positive LPTs were associated with the infected patients. The ROW delivery line was modified to provide a whole disinfection with the HCs connected, avoiding the risk of new contamination of the LPTs. A filtration module of 0.01 mm was added prior to the ROW delivery line. Our experience suggests that outbreaks sustained by unusual bacteria such as
RB and
BB should be promptly investigated to treat the infected patients with the appropriate therapy and to identify the possible source of infection, making the needful changes to achieve a safer dialysis unit.
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