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Peer-reviewedCC BYEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin

Nosocomial outbreak of Ralstonia mannitolilytica associated with prefilled saline flush syringes distributed in Europe, Germany, March to September 2026.

  • Sofia Burdi1
  • Lukas Herrmann1,2,3
  • Sophia N Koerdt4
  • Silver A Wolf5
  • Sandra Appelt6
  • Mirco Sandfort1
  • Barbara Maier7
  • Sandra Reuter7
  • Martin J Hug8
  • Nicholas Jakob Böhm9,10
  • Gizem Karadag9,10
  • Georg Berndt11
20 more authors
  • Achim Dörre1,2
  • Vera Schwierzeck12
  • Linda Behrends12
  • Pascal Kreuzer13
  • Julia Kuhn14
  • Lukas Murajda15
  • Saskia Roßbach16
  • Susanne Kolbe-Busch17
  • Cornelia Seidel18
  • Patrick Jung19
  • Grettel Chanto Chacón20
  • Irina Zuschneid21
  • Somayyeh Sedaghatjoo5
  • Maximilian Driller Povill5
  • Holger C Scholz6
  • Alexander Mellmann12
  • Tim Eckmanns1
  • Josef Zündorf4
  • Michael Hogardt22,23
  • Sebastian Haller1
23 affiliations
  1. 1Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
  2. 2Postgraduate Training for Applied Epidemiology (PAE), Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
  3. 3European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Stockholm, Sweden.
  4. 4Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany.
  5. 5Genome Competence Centre (MF 1), Robert Koch Institute, Berlin, Germany.
  6. 6Centre for Biological Threats and Special Pathogens (ZBS 2), Robert Koch Institute, Berlin, Germany.
  7. 7Institute for Infection Control and Prevention, Medical Center - University of Freiburg, Freiburg, Germany.
  8. 8Pharmacy, Medical Center - University of Freiburg, Freiburg, Germany.
  9. 9National Reference Centre for Surveillance of Nosocomial Infections, Berlin, Germany.
  10. 10Institute of Hygiene and Environmental Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
  11. 11Pharmacy, Charité-Universitätsmedizin Berlin, Berlin, Germany.
  12. 12Institute for Hygiene, University Hospital Münster, Münster, Germany.
  13. 13Health Authority Düsseldorf, Düsseldorf, Germany.
  14. 14Department of Health Protection, Infection control and Epidemiology State Health Office, Ministry of Social Affairs, Labour and Health Baden-Wuerttemberg, Stuttgart, Germany.
  15. 15Health Authority Berlin-Mitte, Berlin, Germany.
  16. 16Infection Prevention and Control Unit, University Hospital Düsseldorf, Düsseldorf, Germany.
  17. 17Institute of Hygiene, Hospital Epidemiology and Environmental Health, University of Leipzig Medical Center, Leipzig, Germany.
  18. 18Städtisches Klinikum Görlitz, Görlitz, Germany.
  19. 19Städtisches Klinikum Karlsruhe, Karlsruhe, Germany.
  20. 20National Reference Centre for Bacteriology, Inciensa, Tres Ríos, Costa Rica.
  21. 21Health Authority Charlottenburg-Wilmersdorf, Berlin, Germany.
  22. 22Institute for Medical Microbiology and Infection Control, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany.
  23. 23German National Consiliary Laboratory on Cystic Fibrosis Bacteriology, Frankfurt am Main, Germany.
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Abstract

A nosocomial outbreak of Ralstonia mannitolilytica bloodstream infections in Germany from March to September 2026 included 16 cases (≤ 6 allelic differences using core genome multilocus sequence typing) across seven hospitals. Epidemiological investigations supported by a large language model, identified prefilled saline flush syringes of one manufacturer as common exposure across all cases. The manufacturer initiated a temporary quarantine and suspension of use of this product. Because it was distributed to other countries, cases may have occurred elsewhere, prompting this report.

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Cite

BibTeXRIS
BibTeX
@article{burdi2026nosocomial,
  title = {{Nosocomial outbreak of Ralstonia mannitolilytica associated with prefilled saline flush syringes distributed in Europe, Germany, March to September 2026.}},
  author = {Sofia Burdi and Lukas Herrmann and Sophia N Koerdt and Silver A Wolf and Sandra Appelt and Mirco Sandfort and Barbara Maier and Sandra Reuter and Martin J Hug and Nicholas Jakob Böhm and Gizem Karadag and Georg Berndt and Achim Dörre and Vera Schwierzeck and Linda Behrends and Pascal Kreuzer and Julia Kuhn and Lukas Murajda and Saskia Roßbach and Susanne Kolbe-Busch and Cornelia Seidel and Patrick Jung and Grettel Chanto Chacón and Irina Zuschneid and Somayyeh Sedaghatjoo and Maximilian Driller Povill and Holger C Scholz and Alexander Mellmann and Tim Eckmanns and Josef Zündorf and Michael Hogardt and Sebastian Haller},
  journal = {Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin},
  year = {2026},
  month = oct,
  doi = {10.2807/1560-7917.es.2026.31.40.2600819},
  url = {https://europepmc.org/article/MED/42852523},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Nosocomial outbreak of Ralstonia mannitolilytica associated with prefilled saline flush syringes distributed in Europe, Germany, March to September 2026.
AU  - Sofia Burdi
AU  - Lukas Herrmann
AU  - Sophia N Koerdt
AU  - Silver A Wolf
AU  - Sandra Appelt
AU  - Mirco Sandfort
AU  - Barbara Maier
AU  - Sandra Reuter
AU  - Martin J Hug
AU  - Nicholas Jakob Böhm
AU  - Gizem Karadag
AU  - Georg Berndt
AU  - Achim Dörre
AU  - Vera Schwierzeck
AU  - Linda Behrends
AU  - Pascal Kreuzer
AU  - Julia Kuhn
AU  - Lukas Murajda
AU  - Saskia Roßbach
AU  - Susanne Kolbe-Busch
AU  - Cornelia Seidel
AU  - Patrick Jung
AU  - Grettel Chanto Chacón
AU  - Irina Zuschneid
AU  - Somayyeh Sedaghatjoo
AU  - Maximilian Driller Povill
AU  - Holger C Scholz
AU  - Alexander Mellmann
AU  - Tim Eckmanns
AU  - Josef Zündorf
AU  - Michael Hogardt
AU  - Sebastian Haller
PY  - 2026
DA  - 2026/10/01
JO  - Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin
DO  - 10.2807/1560-7917.es.2026.31.40.2600819
UR  - https://europepmc.org/article/MED/42852523
AB  - A nosocomial outbreak of Ralstonia mannitolilytica bloodstream infections in Germany from March to September 2026 included 16 cases (≤ 6 allelic differences using core genome multilocus sequence typing) across seven hospitals. Epidemiological investigations supported by a large language model, identified prefilled saline flush syringes of one manufacturer as common exposure across all cases. The manufacturer initiated a temporary quarantine and suspension of use of this product. Because it was distributed to other countries, cases may have occurred elsewhere, prompting this report.
SN  - 1025-496X
SN  - 1560-7917
ER  -