Whole-Genome Analysis of Ralstonia mannitolilytica in a Patient with Hepatocellular Carcinoma

This study presents a case of Ralstonia mannitolilytica isolated from a blood culture of a 50-year-old male patient with hepatocellular carcinoma. The patient underwent ultrasound-guided radiofrequency ablation for liver lesions associated with hepatocellular carcinoma and subsequently experienced recurrent fever, chills, and rigors. R. mannitolilytica was identified from blood culture. This bacterium, known to be an opportunistic pathogen, has not been extensively studied for its whole-genome characteristics and resistance profiles. Through whole-genome sequencing and bioinformatics analysis, we identified 32 distinct drug resistance genes associated with various antibiotic classes, including beta-lactams , aminoglycosides , and fluoroquinolones . Our findings reveal the potential for multidrug resistance in R. mannitolilytica , which exhibited numerous resistance genes. This underscores the clinical challenge of treating infections caused by this bacterium and highlights the importance of whole-genome analysis in understanding emerging pathogens. The identification of these resistance genes is crucial for devising effective clinical strategies to combat infections, particularly in immunocompromised patients, in whom the bacterium may pose a significant risk.