Ralstonia mannitolilytica sepsis: a case report

Abstract

Background: Ralstonia mannitolilytica is an emerging opportunistic pathogen that is associated with severe disease, including septic shock, meningitis, and renal transplant infections. Reports on this pathogen are limited, however, especially on the African continent.

Case presentation: A 2-year-old Akan child was presented to a hospital in the northeastern part of Ghana with a 1-week history of fever and chills. We identified Ralstonia mannitolilytica in her blood culture using both conventional and 16S ribosomal deoxyribonucleic acid (rDNA) techniques. The patient's condition improved clinically upon treatment with cefuroxime.

Conclusion: Our report highlights the potential of Ralstonia mannitolilytica to cause sepsis and thus emphasizes the need for improved laboratory diagnosis and evidence for use of appropriate antibiotics in rural settings of Africa, where presumptive treatment using antimicrobial agents is rife.

Keywords: 16S rRNA; Case report; Nonfermenting gram-negative rods; Ralstonia mannitolilytica; Sepsis.

Fig. 1

Maximum likelihood phylogeny based on 16S rRNA gene sequences. The GenBank accession number for each sequence is provided in parentheses next to the species name abbreviation The genus name is listed to the right of all applicable entries. The levels of bootstrap support based on 1000 replications are labeled above internal branches; only values greater than 50% are listed. On the basis of a BLASTN sequence similarity search against the NCBI 16S rRNA sequence database, the strain G10744 is most similar to the type strain of Ralstonia mannitolilytica (1350/1360 = 99.3% sequence identity). Other representative species from the family Burkholderiaceae are included to infer the phylogenetic placement of G10744. The sequence from Actimicrobium antarcticum (family Oxalobacteraceae) is included as the outgroup to root the phylogeny