Ralstonia species are Gram-negative bacilli of low virulence. These organisms are capable of causing healthcare associated infections through contaminated solutions. In this study, we aimed to determine the source of Ralstonia mannitolilytica bacteraemia in affected patients in a haemodialysis unit. Our laboratory noted an increase in cases of bacteraemia caused by Ralstonia mannitililytica between May and June 2016. All affected patients underwent haemodialysis at the haemodialysis unit of an academic hospital. The reverse osmosis filter of the haemodialysis water system was found to be dysfunctional. We collected water for culture at various points of the dialysis system to determine the source of the organism implicated. ERIC-PCR was used to determine relatedness of patient and environmental isolates. Sixteen patients were found to have Ralstonia mannitolilytica bacteraemia during the outbreak period. We cultured Ralstonia spp. from water collected in the dialysis system. This isolate and patient isolates were found to have the identical molecular banding pattern. All patients were septic and received directed antibiotic therapy. There was 1 mortality. The source of the R. mannitolilytica infection in these patients was most likely the dialysis water as the identical organism was cultured from the dialysis water and the patients. The hospital management intervened and repaired the dialysis water system following which no further cases of R. mannitolilytca infections were detected. A multidisciplinary approach is required to control healthcare associated infections such as these. Routine maintenance of water systems in the hospital is essential to prevent clinical infections with R.mannitolilytica.

中文翻译：

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在南非比勒陀利亚的一家三级医院接受血液透析的患者中出现了罗氏曼尼斯托溶菌菌血症。

罗尔斯通氏菌属是低毒力的革兰氏阴性杆菌。这些生物能够通过被污染的溶液引起医疗保健相关的感染。在这项研究中，我们旨在确定血液透析病房中受影响患者的曼氏罗氏菌菌血症的来源。我们的实验室注意到，2016年5月至6月之间，由马氏疟原虫引起的菌血症病例有所增加。所有受影响的患者都在学术医院的血液透析科接受了血液透析。发现血液透析水系统的反渗透过滤器功能异常。我们在透析系统的各个位置收集了用于培养的水，以确定涉及的生物体来源。ERIC-PCR用于确定患者和环境分离株的相关性。在暴发期间，发现16名患者患有曼氏解脲支原体菌血症。我们培养了Ralstonia spp。收集在透析系统中的水。发现该分离株和患者分离株具有相同的分子谱带模式。所有患者均为脓毒症，并接受了定向抗生素治疗。死亡率为1。这些患者中的马尼罗非球菌感染的来源很可能是透析水，因为从透析水和患者中培养出相同的生物。医院管理人员进行了干预并维修了透析水系统，此后未发现进一步的曼尼托利蝇感染病例。需要多学科的方法来控制诸如此类的医疗保健相关感染。