The Ministry of Health (Minsa) decreed a national health alert after detecting an outbreak of the Ralstonia pickettii bacteria that infected 28 patients in Peruvian hospitals, linked to a contaminated batch of the sedative. Edetoxinused in intensive care units. Although cases are concentrated in newborns, this bacteria can affect patients with low defenses and cause serious infections if it is not detected in time.
Ralstonia pickettii is an environmental bacteria of a gram-negative and aerobic type that is found naturally in water, soil and plants, but can also inhabit the human body without causing harm. Studies published in Current Microbiology and Infection (CMI) and PubMedCentral indicate that this microorganism It can be part of the commensal flora of the oral cavity and upper respiratory tract in healthy people, generally remaining asymptomatic. Described for the first time in 1973, it belongs to the group of non-glucose-fermenting bacilli and is related to species such as Ralstonia solanacearum and Ralstonia mannitolilytica.
Although it is a rare pathogen, its medical relevance has increased due to its ability to adapt to hospital environments and show resistance to certain antibiotics. Specialists consider it a opportunistic pathogenas it only causes serious infections when the patient’s immune system is weakened. In healthy individuals it represents a minimal risk, but can cause significant disease in immunocompromised people or those with chronic conditions, underscoring the importance of its monitoring in clinical settings.
According to the CMI, patients with cystic fibrosis (CF) are the most vulnerable group to infection Ralstonia pickettii. In them, the bacteria can colonize the lungs and cause chronic respiratory infections or long-term pneumonia. Cases have also been recorded in people with diseases such as diabetes mellitusthe alcoholic cirrhosis or in patients undergoing intensive treatments that require prolonged hospitalization.
The most common infections associated with this microorganism include:
- Pneumoniaespecially in patients with cystic fibrosis or prolonged mechanical ventilation.
- Bacteremia or sepsislinked to contaminated catheters and intravenous devices.
- Endocarditisinfection of the inner lining of the heart.
- Meningitiswhen the bacteria reaches the central nervous system.
- Osteomyelitis and septic arthritisin cases of disseminated infection.
- Urinary and wound infectionsalthough they are less common.
These infections can become complicated if they are not identified in time, since the microorganism can be resistant to multiple antibiotics, making its treatment difficult.
He diagnosis of Ralstonia pickettii is done through bacterial cultures on media such as MacConkey agar or through commercial identification systems. However, experts recommend more precise methods, such as polymerase chain reaction (PCR), which allows the bacteria to be detected in early stages or in patients with mixed infections, such as those suffering from cystic fibrosis.
One of the main challenges facing this bacteria is its antimicrobial resistance. CMI studies report that certain strains show resistance to multiple antibiotics due to the production of the enzyme β-lactamase OXA-60, which degrades several antibiotics from the carbapenem group. The resistance percentages observed in clinical isolates are the following:
- Ciprofloxacin: 17%
- Trimethoprim-sulfamethoxazole: 26%
- Aztreonam: 60%
- Piperacillin-tazobactam: 45%
- Ceftriaxone: 40%
- Ceftazidime: 30%
- Imipenem-cilastatin: 38%
- Aminoglycosides: >60%
Treatment usually requires a combination of several medications, including:
- Quinolones
- Third or fourth generation cephalosporins
- Aminoglycosides
Therapeutic results depend on the type of infection and the patient’s immune status. In the most serious cases, especially when there is contaminated devices such as catheters or intravenous systems, it is essential to remove the infected material to control the spread of the bacteria.
Although Ralstonia pickettii infections remain rare, their presence in hospital environments and its ability to resist conventional treatments make it a microorganism of growing clinical interest. Research published in PubMed Central highlights that this type of bacteria should be considered an important cause of healthcare-associated infections, especially among immunosuppressed patients.
In some cases, doctors face difficulty distinguishing between true bacteremia and pseudobacteremia (when contamination occurs outside the body), which can lead to unnecessary treatments. Therefore, experts recommend implementing infection control protocols stricter and strengthen the microbiological surveillance in hospitals.
