投稿分類 感控監測

主委發表種類: 口頭

投稿標題(中): 嬰兒室飲水機檢出羅爾斯頓氏菌處理案例分享

投稿標題(英): The rapid identification and intervention of Ralstonia species in drinking water dispenser from baby room

投稿摘要(前言): Ralstonia species are water-borne aerobic environmental mircoorganism of low pathogenicity belonged to Gram-negative non-fermentative rods. Previous studies indicated that thermally-stable Ralstonia species cause serveral health care-associated outbreaks through water or solutions. The Centers for Disease Control (CDC) stated four cases of newborns infected with Legionnaires' disease in Taiwan on 24 November 2023. Our hospital collected environmental samples, including baby room, pediatric intensive care unit, and postpartum care center for testing. Unexpectedly, The results of the tests on the six samples showed no presence of Legionella species, but Ralstonia species was observed in baby room. We would share our experience about the case of drinking water dispenser contaminated by Ralstonia species in our hospital in 2023.

投稿摘要(方法): At first, the environmental surveillance in Legionella routinely was performed in our hospital based on the Standards「Manual of Standard Operation Procedure of Communicable Diseases」promulgated by Ministry of Health and Welfare in Taiwan. Moreover, the further environmental investigation and active patients surveillance were triggered following the occurrence of Ralstonia species in the baby room. All suspected pathogens were analyzed on the Bruker MALDI Biotyper® system in ISO15189-certified medical laboratories.

投稿摘要(結果): Ralstonia species was identified in water samples from drinking water dispenser in baby room. The pediatricians were advised to evaluate the exposure risks of Ralstonia. All newborns showed no clinical signs of bacterial infection. The water dispenser equipment was replaced immediately and tested to confirm the absence of bacteria before being reactivated. Routine pediatric-related water quality tests have been incorporated into our hospital's internal regulations

投稿摘要(討論): In summary, the previous studies has described that Ralstonia is the opportunistic pathogen in the literature. Thus, a rapid identification by MALDI-TOF and prompt intervention is essential in the prevention of potential infection when Ralstonia species was found in baby room. When routine water quality tests were performed, we should not only to examine the presence of Legionella but also to the potential existence of other opportunistic bacteria that may affect immunocompromised patients. Moreover, the regular cleaning and disinfection of high-risk equipments and environments and could minimize the risk of Ralstonia or Legionella species infection.

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