Abstract
Introduction Ralstonia spp. are nonfermenting gram-negative bacteria that have recently emerged as opportunistic
pathogens. Previously, two case series of infection associated with Ralstonia insidiosa have been published. In this case report, R. insidiosa infection of a neonate in the neonatal intensive care unit (NICU) is presented.
Case Presentation A term male infant developed respiratory distress 2 hours after birth and was admitted
to the NICU with the presumptive diagnosis of transient tachypnea of the newborn.
A left apical pneumothorax was detected, requiring chest tube insertion. An umbilical
catheter was placed due to poor peripheral vascular access. On the second day, blood
cultures were sent from the umbilical artery and umbilical venous catheters, which
showed growth of R. insidiosa. The antibiotics were changed from ampicillin and gentamicin to ampicillin–sulbactam
and cefotaxime according to the antibiotic susceptibility test results. Respiratory
distress symptoms resolved and the patient was extubated. The infant's clinical condition
improved steadily and was discharged with breast feeding and stable vital findings,
negative follow-up cultures, and C-reactive protein.
Conclusion Ralstonia insidiosa is an emerging pathogen in hospital infections due to its ability to survive in water
supplies and sterilized water-based solutions. There is need for vigilance of R. insidiosa, especially in intensive care units. Awareness of rare pathogens, early detection
of the bacteria, and antibiotic susceptibility test results are important in the success
of treatment.
Keywords
Ralstonia insidiosa
- sepsis - neonate
