Ralstonia spp

  • R. insidiosa
  • R. mannitolytica
  • R. pickettii
Gram Stain
  • Gram negative straight/slightly curved bacilli - nonfermenter (aerobic)

Clinical Significance

These organisms are found in a variety of sources including soil, water, and hospital environments.

They are primarily plant pathogens with low pathogenic potential but can cause nosocomial infections including bacteremia, meningitis (including recurrent meningitis), endocarditis, peritonitis (including CAPD peritonitis), and osteomyelitis.

They have been associated with nosocomial outbreaks due to contamination of intravenous medications, disinfectant solutions, water, saline, and respiratory solutions. 

They have been isolated from cystic fibrosis patients where their role has not been fully established.

 

Usual Susceptibility Pattern

These organisms are resistant to aminoglycosides and narrow spectrum beta lactam agents. 

Third generation cephalosporin susceptibility is variable (ceftazidime MICs are higher than cefotaxime).

They are usually susceptible to TMP/SMX, quinolones, and carbapenems.

Colistin susceptibility is variable.

Empiric Therapy
TMP/SMX
or
Ciprofloxacin