Epidemiological and genomic characteristics of <i>Ralstonia mannitolilytica</i> isolated from bloodstream in Liaocheng City, Shandong Province, China

<i>Ralstonia mannitolilytica</i>, an environmental bacterium increasingly linked to hospital-acquired infections, poses significant treatment challenges due to its resistance to common antibiotics. This study investigates 11 bloodstream infection cases caused by <i>R. mannitolilytica</i> in a Chinese hospital, revealing two distinct transmission clusters through genomic analysis. The findings highlight the bacterium's ability to persist in clinical settings and its resistance to critical antibiotics like carbapenems, likely driven by intrinsic genes and efflux pumps. By combining patient data and genomic surveillance, this work underscores the urgent need for enhanced infection control measures to curb outbreaks. It also provides novel comparative genomic insights into <i>R. mannitolilytica</i>, advancing our understanding of its evolution and resistance mechanisms, which is vital for guiding future clinical management and public health strategies.