title: Ralstonia picketti neonatal sepsis: a case report.
abstract: BACKGROUND
  Ralstonia genus are gram negative bacillus and includes four bacteria namely Ralstonia picketti, Ralstonia Solanacearum, Ralstonia insidiosa and Ralstonia mannitolilytica. These are opportunistic pathogens and cause infections in immunocompromised host. The sources of infection are usually contaminated solutions and water. The majority of the reported cases are caused by R. picketti. It is very rare cause of neonatal sepsis with less than twenty cases reported in literature till date.
  
  
  METHODS
  A late preterm male infant, Indian race was admitted to the neonatal intensive care unit for respiratory distress developing soon after birth. The infant was managed with respiratory support and gradually infant improved and diagnosis of transient tachypnea of newborn was made. At age of 84 h of postnatal life, the infant developed features of neonatal sepsis and investigations were suggestive of sepsis. The infant was started on intravenous antibiotic, multiple vasopressors and steroids. The blood culture showed growth of multi-drug resistant R. picketti. The antibiotics were changed as per sensitivity pattern and infant was discharged in good condition and was accepting breast feeding at the time of discharge. There was also no other case of R. picketti in the nursery during the same time period.
  
  
  CONCLUSIONS
  Ralstonia picketti is an uncommon cause of neonatal sepsis and usually source of infection are contaminated solutions and medical products. The management involves early detection, treatment with appropriate antibiotics and doing surveillance culture to identify the possible source of infection.
authors.affiliation: NEOCLINIC, TN Mishra Marg, Everest Vihar, Nirman Nagar, Jaipur, Rajasthan, India. dr.deepak.rohtak@gmail.com.
authors.forename: Deepak
authors.initials: D
authors.lastname: Sharma
authors.affiliation: Department of Medicine, Mahatma Gandhi Medical College, Jaipur, Rajasthan, India.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Sharma
authors.affiliation: Department of Microbiology, J.L.N Medical College, Ajmer, Rajasthan, India.
authors.forename: Priyanka
authors.initials: P
authors.lastname: Soni
authors.affiliation: Department of Pediatrics, Civil Hospital, Palwal, Haryana, India.
authors.forename: Basudev
authors.initials: B
authors.lastname: Gupta
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D007194:India; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal; D008297:Male; D000071074:Neonatal Sepsis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology*; D043367:Ralstonia / Q000145:classification / Q000302:isolation & purification*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Neonate; Ralstonia picketti; Sepsis