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

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.