Journal
INFECTION AND DRUG RESISTANCE
Volume 15, Issue -, Pages 3841-3845Publisher
DOVE MEDICAL PRESS LTD
DOI: 10.2147/IDR.S370170
Keywords
Ralstonia mannitolilytica; kidney transplant; sepsis; metagenomic next-generation sequencing; mNGS; blood cultures
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Funding
- Project of Science and Technology of Henan Province [202102310438]
- 23456 Talent Project Foundation of Henan Provincial People's Hospital [ZC23456127]
- Joint Construction Project of Henan Medical Science and Technology Research Plan [LHGJ20210042]
- Foundation of Henan Educational Committee [22A320012]
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This article presents a case of septic shock in a male kidney transplant recipient caused by Ralstonia mannitolilytica. The patient eventually recovered after treatment with sensitive antibiotics. The study highlights the importance of considering Ralstonia mannitolilytica as a potential cause of septic shock in kidney transplant recipients.
Background: Ralstonia mannitolilytica, an emerging opportunistic pathogen, can infect immunocompromised patients but is a rare cause of severe sepsis and septic shock in kidney transplant recipients (KTRs). Case Presentation: We present a case of septic shock after renal transplant in a 41-year-old male, which was finally proven to be caused by Ralstonia mannitolilytica through blood cultures and mass spectrometric analysis following the negative result of metagenomic next-generation sequencing (mNGS). He was finally cured after the application of sensitive antibiotics (sulfamethoxazole-trimethoprim, amikacin and piperacillin-tazobactam) based on the drug sensitivity test results. The patient had a satisfactory recovery with no complications during a 6-month follow-up period. Conclusion: This study highlights that Ralstonia mannitolilytica is an easily overlooked cause of septic shock in KTRs requiring a detailed inquiry of medical history with inflammatory markers monitored closely. Traditional blood cultures still should be taken seriously. It also provides a cautionary tale that negative results of mNGS have to be interpreted with caution.
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