Ralstonia mannitolilytica as a Cause of Postoperative Endophthalmitis

Purpose: To report the clinical and microbiological characteristics of 5 cases of postsurgical endophthalmitis caused by Ralstonia mannitolilytica and to review the relevant literature. Methods: Medical records of patients diagnosed with endophthalmitis due to Ralstonia mannitolilytica were retrospectively reviewed. The organism was identified using an automated VITEK system, while antibiotic susceptibility testing was conducted using standard microbiologic protocols. Primary outcome measures included infection control, visual improvement at 4 to 6 weeks of follow-up, and the antibiotic sensitivity profile of Ralstonia . Results: Infection control was achieved in all cases. Visual outcomes were excellent in 3 out of 5 cases. All isolates demonstrated in vitro susceptibility to ciprofloxacin but differential sensitivity to ceftazidime. Conclusions: To our knowledge, this is the first reported case series of culture-proven R. mannitolilytica endophthalmitis. This series highlights the importance of accurate identification and antibiotic susceptibility-tailored management in infections caused by rare organisms such as Ralstonia .