Objective:

To report a case of a PICC-related bloodstream infection caused by multidrug-resistant Ralstonia mannitolilytica and demonstrate the effectiveness of topical minocycline in treatment, highlighting its potential as an alternative when standard options are not viable.

Key Findings:

• Blood cultures confirmed the presence of Ralstonia mannitolilytica, which was multidrug-resistant, underscoring the challenge of treating such infections.
• Topical minocycline combined with systemic antibiotics led to successful infection control, demonstrating a potential alternative treatment pathway.
• The PICC catheter remained functional without complications throughout the treatment, indicating the feasibility of retaining the catheter under these circumstances.

Interpretation:

This case highlights the potential of topical minocycline as a salvage therapy for CRBSI caused by MDR pathogens, particularly when catheter removal is not an option, suggesting a need for further exploration of this treatment modality.

Limitations:

• The case is a single patient report, limiting generalizability and necessitating caution in applying findings to broader populations.
• Lack of extensive clinical data on topical minocycline use for CRBSI caused by Ralstonia mannitolilytica highlights the need for more comprehensive studies.

Conclusion:

Topical minocycline may be a viable alternative treatment for CRBSI in patients unable to undergo catheter removal, warranting further investigation in larger studies to validate these findings.