Déjà vu: Ralstonia mannitolilytica infection associated with a humidifying respiratory therapy device, Israel, June to July 2011

C Block; Z Ergaz-Shaltiel; L Valinsky; V Temper; C Hidalgo-Grass; N Minster; C Weissman; S Benenson; J Jaffe; A E Moses; B Bar-Oz

doi:10.2807/ese.18.18.20471-en

Surveillance and outbreak reports Open Access

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Déjà vu: Ralstonia mannitolilytica infection associated with a humidifying respiratory therapy device, Israel, June to July 2011
C Block¹ , Z Ergaz-Shaltiel² , L Valinsky³ , V Temper¹ , C Hidalgo-Grass¹ , N Minster¹ , C Weissman⁴ , S Benenson¹ , J Jaffe³ , A E Moses¹ , B Bar-Oz²
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Affiliations: ¹ Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Centre, Jerusalem, Israel ² Department of Neonatal Medicine, Hadassah-Hebrew University Medical Centre, Jerusalem, Israel ³ Laboratory of Molecular Biology, Israel Ministry of Health, Jerusalem, Israel ⁴ Department of Anaesthesiology, Hadassah-Hebrew University Medical Centre, Jerusalem, Israel

Correspondence:
C Block
colinb ekmd.huji.ac.il
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Citation style for this article: Block C, Ergaz-Shaltiel Z, Valinsky L, Temper V, Hidalgo-Grass C, Minster N, Weissman C, Benenson S, Jaffe J, Moses A E, Bar-Oz B. Déjà vu: Ralstonia mannitolilytica infection associated with a humidifying respiratory therapy device, Israel, June to July 2011. Euro Surveill. 2013;18(18):pii=20471. https://doi.org/10.2807/ese.18.18.20471-en Received: 20 Jul 2012

Abstract

Following a bloodstream infection in June 2011 with Ralstonia mannitolilytica in a premature infant treated with a humidifying respiratory therapy device, an investigation was initiated at the Hadassah Medical Centres in Jerusalem. The device delivers a warmed and humidified mixture of air and oxygen to patients by nasal cannula. The investigation revealed colonisation with R. mannitolilytica of two of 15 patients and contamination of components of five of six devices deployed in the premature units of the Hadassah hospitals. Ten isolates from the investigation were highly related and indistinguishable from isolates described in an outbreak in 2005 in the United States (US). Measures successful in containing the US outbreak were not included in user instructions provided to our hospitals by the distributor of the device.