Outbreak of Ralstonia mannitolytica bacteremia in the paediatric critical unit due to intrinsic contamination of dexmedetomidine.

There were 17 episodes of Ralstonia mannitolytica blood stream Infection (BSI) in the pediatric cardiac intensive care unit (PCICU) of a tertiary care hospital from June 22 to Aug 24. All infection control processes were reviewed and audited after each BSI. No major breach in infection control was noted. Cultures were sent from the environment, intravenous fluids, disinfectants, antiseptics and medication after every BSI. Culture from unused vials of the sedative drug dexmedetomidine in Aug'24 grew R.mannitolytica after incubation of 4 days. There were no further cases till October'25. This outbreak was linked to intrinsic contamination of medication.