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A urokinase-associated outbreak of Ralstonia mannitolilytica bloodstream infections in haemodialysis patients in north-eastern Italy, January to April 2023
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View Affiliations Hide AffiliationsMassimiliano Fabriccimassimiliano.fabricci asugi.sanita.fvg.it
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Multidisciplinary working group: Fabio Barbone, Elisa Bedina, Tania Bottacin, Alice Cara, Leda Cipriani, Roberto Cocconi, Maryluz Cordova Luna, Pierlanfranco D’Agaro, Stefano Di Bella, Manuela Di Santolo, Stefano Dolce, Roberta Fais, Francesco Fontana, Antonietta Guerra, Claudia Lucarelli, Francesco Maraglino,, Massimiliano Martone, Cristina Maurel, Lucia Mian, Jacopo Monticelli, Alberto Pagotto, Ketty Parenzan, Patrizio Pezzotti, Alessandro Pipoli, Chiara Roni, Michela Sabbatucci,, Assunta Sartor, Paolo Schincariol, Carlo Tascini, Massimiliano Tosto, Gabriele TurelloView Citation Hide Citation
Citation style for this article: . A urokinase-associated outbreak of Ralstonia mannitolilytica bloodstream infections in haemodialysis patients in north-eastern Italy, January to April 2023. Euro Surveill. 2023;28(28):pii=2300328. https://doi.org/10.2807/1560-7917.ES.2023.28.28.2300328 Received: 28 Jun 2023; Accepted: 13 Jul 2023
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Abstract
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.
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