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Shiv Mirani: Annotated Bibliography
The Delftia acidovorans bacteria is gram-negative and utilizes oxygen, aka is aerobic. This source primarily describes a case study of a "68 year old woman suffering from D.acidovorans based pneumonia who has B cell lymphoblastic leukemia and undergoes successful therapy using antibiotics". The patient was hooked up with antibiotics through IV's such as "piperacillin-tazobactam, ciprofloxacin, vincristine and prednisolone" after she was diagnosed with having pneumonia with cough and sputum. Within the first week of treatment she became Neutropenic but recovered completely after 27 days. The bacteria was identified as D.acidovorans through the usage of MacConkey agar by the Vitek spectrometer. Pneumonia is not the only case having been reported to be associated with D.acidovorans, with infections such as "endocarditis, bacterimia within catheters, peritonitis, and urinary tract infection" also having to do with D.acidovorans in various cases. A table is given in this source to further identify certain individual cases with diseases caused by D.acidovorans and the treatments administered along with whether the treatment was successful or not. As a result most of the treatments in the cases shown were successful.

This source used a case study of a "30 year old male who has been an intermittent drug user (IDU) in the past and has post-traumatic stress disorder and Hepatitis C as well". The patient initially developed a fever and a cough for which he got treated at the emergency room. After receiving negative blood work, he was administered "vancomycin and piperacillin-tazobactam". An "aortic valve replacement was conducted due to occlusions in the right posterior tibial artery and right perineal artery". Following the procedure, ceftriaxone and bacteremia were administered after which he was shortly discharged. At time of testing, multiple blood cultures were ordered which utilized the gram strain procedure. This revealed the presence of "gram negative bacilli having grown in multiple sources such as chocolate, MacConkey Agar, and sheep blood. The bacilli was identified as Delftia acidovorans at a 99.17% accuracy probability". The source stated that the probability of encountering an IDU patient with endocarditis is rare especially those that are caused by a gram-negative bacilli which are about 1% of all cases. The conclusion was made that "D.acidovorans is able to cause endocarditis in which the native valve is severely damaged resulting in large arterial emboli".

The article uses a case study of a "70 year old patient with Type II Diabetes and prominent lower limb peripheral oedema". The source states that there had been no previous cases of Delftia acidovorans as a skin infection, in the literature review. The patient was suffering from a bilateral lower limb cellulitis and right heart failure. A wound sample was cultured which led to in the growth of D.acidovorans and the results showed that the bacteria were "sensitive to ciprofloxacin and co-trimoxazole antibiotics, but were resistant to antibiotics such as gentamicin, amikacin, tobramycin, and amoxycillin. A skin testing following the administration of the antibiotics resulted in the "healing of the erythema and the associated skin changes to return to normal conditions". Additionally, "the rise of CRP after taking empirical cephazolin, and its reduction after taking ciprofloxacin" supports the idea that D.acidovorans is the primitive cause for the skin disease given that the bacteria is sensitive to ciprofloxacin. The article is concluded by mentioning that individuals who are immunocompromised and/or immunocompetent, are more likely to acquire a pathogen which may cause the aforementioned skin disease.

Delftia acidovorans can be identified by using Kovac's reagent over a media which would result in an orange color, if positive, from the production of anthranilic acid by tryptophan. This procedure is used to identify D.acidovorans in the case of a 4 year old child who was taken to the emergency room due to high fever, cough, and trouble breathing. Blood-work was tested which had all come back negative, however 3 days after the patient was admitted, the child was diagnosed with empyema following X ray results. The patient received an intercostal drainage tube (ICD) through which he received "injection Ceftazidime and Injection Amikacin". The ICD was removed after a week to be sampled over sheep blood and MacConkey agar and resulted in colony growth and an orange color. The article is concluded by stating that some of the reasons that the author believes that D.acidovorans may be the primitive cause for infection are the production of the orange dye in the agar tests, and the organism's resistance to aminoglycosides such as Amikacin.

The Delftia acidovorans bacteria can infect humans through various means such as "water, devices, and equipment". The likelihood of contracting the infection can be increased in people that are contaminated with unsanitary water and are recreational drug users. Testing of cultures from tracheal aspirate were conducted using MacConkey agar and blood agar. The 165rRNA methylase was present in the culture which is responsible for indicating resistance of gram negative bacteria to aminoglycosides. D.acidovorans was found from the result of the samples and is considered as a pathogenic agent due to it's presence in the tested septum.