A urokinase-associated outbreak of Ralstonia mannitolilytica bloodstream infections in haemodialysis patients in north-eastern Italy, January to April 2023

Fabricci, Massimiliano; Trinca, Anaïs; Talotti, Luca; Busetti, Marina; Fotakis, Emmanouil Alexandros; Merakou, Christina; Koncan, Raffaella; Ghiotti, Annachiara; Negri, Camilla; Di Maso, Vittorio; Bosco, Manuela; Antonelli, Alberto; Coppi, Marco; Rossolini, Gian Maria; Giuliani, Claudia; Scarpis, Enrico; Gregoretti, Barbara; Licastro, Danilo; Luzzati, Roberto; Costantino, Venera; Multidisciplinary Working Group,

doi:10.2807/1560-7917.ES.2023.28.28.2300328

An outbreak of Ralstonia mannitolilytica bloodstream infections occurred in four hospitals in north-eastern Italy, involving 20 haemodialysis patients with tunnelled central vascular catheter access. We identified as the outbreak source a batch of urokinase vials imported from India contaminated with R. mannitolilytica. Whole genome sequences of the clinical and urokinase strains were highly related, and only urokinase-treated patients were reported with R. mannitolilytica infections (attack rate = 34%; 95% confidence interval: 22.1-47.4). Discontinuation of the contaminated urokinase terminated the outbreak.

A urokinase-associated outbreak of Ralstonia mannitolilytica bloodstream infections in haemodialysis patients in north-eastern Italy, January to April 2023 / Fabricci, M., Trinca, A., Talotti, L., Busetti, M., Fotakis, E.A., Merakou, C., Koncan, R., Ghiotti, A., Negri, C., Di Maso, V., Bosco, M., Antonelli, A., Coppi, M., Rossolini, G.M., Giuliani, C., Scarpis, E., Gregoretti, B., Licastro, D., Luzzati, R., Costantino, V., et al.. - In: EUROSURVEILLANCE. - ISSN 1560-7917. - ELETTRONICO. - 28:28(2023), pp. 2300328."-"-2300328."-". [10.2807/1560-7917.ES.2023.28.28.2300328]