Epidemiological survey of concentrated outbreaks of Ralstonia mannitolilytica bloodstream infection in 11 patients
OBJECTIVE To explore the clinical characteristics of bloodstream infection caused by Ralstonia manni-tolilytica in 11 patients,observe the transmission routes of nosocomial infection,investigate the suspected R.mannitolilytica bloodstream infection,find out the source of infection and transmission routes so as to prevent the outbreak of nosocomial infection.METHODS A total of 11 patients who were hospitalized in Liaocheng Third Peo-ple's Hospital and detected with R.mannitolilytica by blood culture from Jan 2019 to Mar 2020 were recruited as the study subjects.2 cases of R.mannitolilytica bloodstream infection were reported by the same department through blood culture on November 8,the infection control professionals hurried off to the department for inspec-tion,the literatures were reviewed for collection of suspected cases of nosocomial infection,the cases were repor-ted to division heads,the director nursing heads from medical administration department,nursing department,microbiological laboratory and related departments were gathered for discussion so as to find out the risk factors for the infection,the samples were collected from the related objects and environment.The municipal center for diseases control and prevention(CDC)was invited to guide the epidemiological survey and sampling.RESULTS All of the 11 patients has chills and fever at the onset of disease,10 patients had underlying diseases,10 strains of R.mannitolilytica were resistant to meropenem,the infection occurred in the same ward building(Block B).Totally 60 sets of samples were collected from humidifying water of central air conditioner,air conditioner vents of wars of infection cases,oxygen inhalation humidifying water,hand-washing running water,skin mucosa and hand disin-fectants and oxygen inhalation pipelines,and all of the samples were not detected with R.mannitolilytica.CONCLUSION The 11 cases of R.mannitolilytica bloodstream infection show the similar drug resistance spectrum and were highly homologous.Although the origin of the bloodstream infection is unclear,there may be risk factors for cross infection in the ward building,and it is worthy to be further studied.
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