{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T05:19:50Z","timestamp":1741238390610,"version":"3.38.0"},"reference-count":16,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,5]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p><jats:italic>Ralstonia<\/jats:italic> species are recently emerging as pathogens of human importance. This study was performed to assess the distribution of <jats:italic>Ralstonia<\/jats:italic> species among bacteremia patients and the clinical and demographical factors of these patients. This retrospective observational study was performed in the Microbiology Department of a tertiary care center in North India from April 2022 to April 2024. All in-patients with blood cultures positive for <jats:italic>Ralstonia<\/jats:italic> species for the first time during the study period were included in the study. Positive blood cultures were inoculated on blood and MacConkey agar. Identification was done by matrix-assisted laser desorption ionization\u2013time of flight mass spectrometry, and antibiotic sensitivity testing was determined by disc diffusion assay. During the study period, 26 isolates of <jats:italic>Ralstonia<\/jats:italic> species were identified. <jats:italic>R. mannitolilytica<\/jats:italic> was the predominant isolate, followed by <jats:italic>R. pickettii<\/jats:italic>. Most patients with <jats:italic>Ralstonia<\/jats:italic> bacteremia belonged to the age group of &lt;60 years (<jats:italic>n<\/jats:italic> = 20; 78%). The median age of the study population was 62 years. The male-to-female ratio was 1.6:1. Most of the patients presented with complaints of fever (77%), followed by epigastric pain (38.4%). Among the underlying comorbidities, most of the patients with <jats:italic>Ralstonia<\/jats:italic> bacteremia had sepsis (73%), followed by multiorgan dysfunction syndrome (30.7%). None of the <jats:italic>R. mannitolilytica<\/jats:italic> isolates showed sensitivity to imipenem, meropenem, aztreonam, and ceftazidime. On comparing both the isolates, <jats:italic>R. pickettii<\/jats:italic> showed better sensitivity to amikacin, imipenem, meropenem, aztreonam, and ceftazidime than <jats:italic>R. mannitolilytica<\/jats:italic>. Overall mortality of the patients in the study was 22% (<jats:italic>n<\/jats:italic> = 6).<\/jats:p>","DOI":"10.4269\/ajtmh.24-0421","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T18:35:26Z","timestamp":1733855726000},"page":"539-543","source":"Crossref","is-referenced-by-count":0,"title":["Changing Trends of Ralstonia Bacteremia in Patients at a Tertiary Care Center in North India: A 2-Year Retrospective Analysis"],"prefix":"10.4269","volume":"112","author":[{"given":"Ashima","family":"Jamwal","sequence":"first","affiliation":[{"name":"Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerlin","family":"Varghese","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarvodaya","family":"Tripathy","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepika","family":"Sarawat","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sangram Singh","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitra","family":"Kar","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nidhi","family":"Tejan","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chinmoy","family":"Sahu","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Rev Bras Ter Intensiva","first-page":"195","article-title":"Ralstonia pickettii bacteremia in hemodialysis patients: A report of two cases","volume":"28","author":"Tejera","year":"2016"},{"key":"b2","series-title":"Access Microbiol","first-page":"acmi000367","article-title":"Ralstonia mannitolilytica: An emerging multidrug-resistant opportunistic pathogen in a tertiary care hospital setting","volume":"4","author":"Siddiqui","year":"2022"},{"key":"b3","series-title":"Antimicrob Resist Infect Control","first-page":"117","article-title":"Outbreak of Ralstonia mannitolilytica bacteraemia in patients undergoing haemodialysis at a tertiary hospital in Pretoria, South Africa","volume":"9","author":"Said","year":"2020"},{"key":"b4","series-title":"Antonie Van Leeuwenhoek","first-page":"1721","article-title":"Characterization of clinical Ralstonia strains and their taxonomic position","volume":"114","author":"Fluit","year":"2021"},{"key":"b5","series-title":"BMC Infect Dis","first-page":"327","article-title":"Persistent bacteremia caused by Ralstonia pickettii and Microbacterium: A case report","volume":"24","author":"Wang","year":"2024"},{"key":"b6","series-title":"J Korean Med Sci","first-page":"e252","article-title":"Clinical manifestation of Ralstonia mannitolilytica infection in pediatric patients and epidemiological investigation of outbreaks","volume":"38","author":"Kim","year":"2023"},{"key":"b7","series-title":"Antibiotics (Basel)","first-page":"1376","article-title":"Antimicrobial treatment on a catheter-related bloodstream infection (CRBSI) case due to transition of a multi-drug-resistant Ralstonia mannitolilytica from commensal to pathogen during hospitalization","volume":"11","author":"Liu","year":"2022"},{"key":"b8","series-title":"Cureus","first-page":"e5084","article-title":"Ralstonia pickettii bacteremia: An emerging infection in a tertiary care hospital setting","volume":"11","author":"Nasir","year":"2019"},{"key":"b9","series-title":"Genome Announc","first-page":"e00027-14","article-title":"Draft genome sequence of Ralstonia pickettii AU12-08, isolated from an intravascular catheter in Australia","volume":"2","author":"Zhang","year":"2014"},{"key":"b10","series-title":"Clin Microbiol Infect","first-page":"99","article-title":"Ralstonia pickettii\u2014Innocent bystander or a potential threat?","volume":"12","author":"Stelzmueller","year":"2006"},{"year":"2024","series-title":"Performance Standards for Antimicrobial Susceptibility Testing, CLSI Supplement M100","key":"b11"},{"year":"2024","series-title":"Breakpoint Tables for Interpretation of MICs and Zone Diameters, Version 14.0, 2024","key":"b12"},{"key":"b13","series-title":"Infect Drug Resist","first-page":"1339","article-title":"Bloodstream infections caused by drug resistant Ralstonia species: A case series during the COVID-19 pandemic","volume":"16","author":"Alnimr","year":"2023"},{"key":"b14","series-title":"Hemodial Int","first-page":"E83","article-title":"Outbreak of nonfermentative Gram-negative bacteria (Ralstonia pickettii and Stenotrophomonas maltophilia) in a hemodialysis center","volume":"23","author":"Thet","year":"2019"},{"key":"b15","series-title":"Acta Microbiol Immunol Hung","first-page":"158","article-title":"Ralstonia pickettii bacteremia in a cardiac surgery patient in Belgrade, Serbia","volume":"69","author":"Jovicevic","year":"2022"},{"key":"b16","series-title":"Antimicrob Resist Infect Control","first-page":"20","article-title":"Ralstonia mannitolilytica infections in an oncologic day ward: Description of a cluster among high-risk patients","volume":"6","author":"Lucarelli","year":"2017"}],"container-title":["The American Journal of Tropical Medicine and 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