title: Déjà vu: Ralstonia mannitolilytica infection associated with a humidifying respiratory therapy device, Israel, June to July 2011.
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.
authors.affiliation: Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Centre, Jerusalem, Israel. colinb@ekmd.huji.ac.il
authors.forename: C
authors.initials: C
authors.lastname: Block
authors.forename: Z
authors.initials: Z
authors.lastname: Ergaz-Shaltiel
authors.forename: L
authors.initials: L
authors.lastname: Valinsky
authors.forename: V
authors.initials: V
authors.lastname: Temper
authors.forename: C
authors.initials: C
authors.lastname: Hidalgo-Grass
authors.forename: N
authors.initials: N
authors.lastname: Minster
authors.forename: C
authors.initials: C
authors.lastname: Weissman
authors.forename: S
authors.initials: S
authors.lastname: Benenson
authors.forename: J
authors.initials: J
authors.lastname: Jaffe
authors.forename: A E
authors.initials: AE
authors.lastname: Moses
authors.forename: B
authors.initials: B
authors.lastname: Bar-Oz
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003091:Colistin / Q000627:therapeutic use; D004196:Disease Outbreaks / Q000706:statistics & numerical data; D004203:Disinfection / Q000379:methods; D024881:Drug Resistance, Bacterial; D004866:Equipment Contamination; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D006801:Humans; D006813:Humidity / Q000009:adverse effects; D007231:Infant, Newborn; D007234:Infant, Premature; D007557:Israel / Q000453:epidemiology; D010102:Oxygen Inhalation Therapy / Q000009:adverse effects / Q000295:instrumentation*; D049920:Ralstonia pickettii / Q000254:growth & development / Q000302:isolation & purification*; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D003091:Colistin