Bacteremia due to Ralstonia mannitolilytica: A report of the first case in Peru

The first report of Ralstonia mannitolilytica bacteremia in Peru is presented. The patient was a pediatric cancer patient with a long-term central venous access device. For the diagnosis, the MicroScan Walk Away 96 automated system was used. 16S rDNA was amplified by conventional PCR, and the bacterial genus and species were identified by genetic sequencing. In addition, the bacterial resistance profile to major antimicrobials was determined. The article discusses the need to actively monitor Ralstonia mannitolilytica, especially in hospital areas of immunocompromised patients.

Risk Factors for Central Venous Access Device-Related Thrombosis in Hospitalized Children: A Systematic Review and Meta-Analysis

Objective To identify the potential associations of patient-, treatment-, and central venous access device (CVAD)-related factors with the CVAD-related thrombosis (CRT) risk in hospitalized children. Methods A systematic search of PubMed, EMBASE, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, Wanfang, and VIP database was conducted. RevMan 5.3 and Stata 12.0 statistical software were employed for data analysis. Results In terms of patient-related factors, the patient history of thrombosis (odds ratio [OR] = 3.88, 95% confidence interval [CI]: 2.57–5.85), gastrointestinal/liver disease (OR = 1.85, 95% CI: 0.99–3.46), hematologic disease (OR = 1.45, 95% CI: 1.06–1.99), and cancer (OR = 1.58, 95% CI: 1.01–2.48) were correlated with an increased risk of CRT. In terms of treatment-related factors, parenteral nutrition (PN)/total PN (OR = 1.70, 95% CI: 1.21–2.39), hemodialysis (OR = 2.17, 95% CI: 1.34–3.51), extracorporeal membrane oxygenation (OR = 1.51, 95% CI: 1.31–1.71), and cardiac catheterization (OR = 3.92, 95% CI: 1.06–14.44) were associated with an increased CRT risk, while antibiotics (OR = 0.46, 95% CI: 0.32–0.68) was associated with a reduced CRT risk. In terms of the CVAD-related factors, CRT risk was more significantly increased by peripherally inserted central catheter than tunneled lines (OR = 1.81, 95% CI: 1.15–2.85) or totally implantable venous access port (OR = 2.81, 95% CI: 1.41–5.60). And subclavian vein catheterization significantly contributed to a lower CRT risk than femoral vein catheterization (OR = 0.36, 95% CI: 0.14–0.88). Besides, multiple catheter lines (OR = 4.06, 95% CI: 3.01–5.47), multiple catheter lumens (OR = 3.71, 95% CI: 1.99–6.92), central line-associated bloodstream infection (OR = 2.66, 95% CI: 1.15–6.16), and catheter malfunction (OR = 1.65, 95% CI: 1.07–2.54) were associated with an increased CRT risk. Conclusion The exact identification of the effect of risk factors can boost the development of risk assessment tools with stratifying risks.