{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:57:56Z","timestamp":1790193476450,"version":"4.1.0"},"reference-count":36,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Delftia acidovorans (D. acidovorans) is a non-fermentative, aerobic, Gram-negative bacillus typically found in environmental sources such as soil and water. Although considered an opportunistic pathogen, it has been implicated in both immunocompromised and immunocompetent individuals. This study presents a case of persistent cathether-related bacteraemia in a 61-year-old haemodialysis patient and offers a systematic literature review of similar cases. The patient, affected by end-stage kidney disease and dependent on a central venous catheter (CVC), presented with septic shock. Blood cultures confirmed D. acidovorans, resistant to aminoglycosides but sensitive to cephalosporins, piperacillin\/tazobactam, and fluoroquinolones. Despite appropriate antibiotic therapy, bacteraemia persisted, prompting the use of taurolidine lock therapy when catheter removal was initially unfeasible. Blood cultures cleared after nine days, and the catheter was later replaced. A systematic review following PRISMA guidelines identified 21 additional cases of D. acidovorans bacteraemia. Most (76.2%) occurred in immunocompromised patients, particularly those with malignancies, chronic haemodialysis, or indwelling devices. Infections in immunocompetent individuals were typically associated with intravenous drug use or environmental exposure. Mortality was approximately 19%. Aminoglycoside resistance was consistent across most cases, while susceptibility to piperacillin\/tazobactam, cephalosporins, and carbapenems was generally preserved. Given its resistance profile and ability to form biofilms, D. acidovorans poses a management challenge, particularly in catheter-associated infections. Rapid identification and targeted antimicrobial therapy are crucial. Adjunctive measures such as taurolidine lock therapy can be beneficial when device removal is not immediately possible.<\/jats:p>","DOI":"10.3390\/antibiotics14040365","type":"journal-article","created":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T05:43:33Z","timestamp":1743572613000},"page":"365","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Delftia acidovorans Infections in Immunocompetent and Immunocompromised Hosts: A Case Report and Systematic Literature Review"],"prefix":"10.3390","volume":"14","author":[{"given":"Vincenzo","family":"Scaglione","sequence":"first","affiliation":[{"name":"Infectious and Tropical Diseases Unit, Padua University Hospital, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia Federica","family":"Stefanelli","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, Padua University Hospital, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0263-0703","authenticated-orcid":false,"given":"Maria","family":"Mazzitelli","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Diseases Unit, Padua University Hospital, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leda","family":"Cattarin","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, Padua University Hospital, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loreta","family":"De Giorgi","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, Padua University Hospital, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Naso","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, Padua University Hospital, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7218-7762","authenticated-orcid":false,"given":"Alberto Enrico","family":"Maraolo","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2869-2945","authenticated-orcid":false,"given":"Annamaria","family":"Cattelan","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Diseases Unit, Padua University Hospital, 35128 Padua, Italy"},{"name":"Department of Molecular Medicine, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1167-2764","authenticated-orcid":false,"given":"Federico","family":"Nalesso","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, Padua University Hospital, 35128 Padua, Italy"},{"name":"Department of Molecular Medicine, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Hojgaard, S.M.M., Rezahosseini, O., Knudsen, J.D., Fuglebjerg, N.J.U., Skov, M., Nielsen, S.D., and Harboe, Z.B. (2022). Characteristics and Outcomes of Patients with Delftia acidovorans Infections: A Retrospective Cohort Study. Microbiol. Spectr., 10.","DOI":"10.1128\/spectrum.00326-22"},{"key":"ref_2","first-page":"52","article-title":"Reclassification of Pseudomonas acidovorans den Dooren de Jong 1926 and Pseudomonas testosteroni Marcus and Talalay 1956 as Comamonas acidovorans comb. nov. and Comamonas testosteroni comb. nov., with an Emended Description of the Genus Comamonas","volume":"37","author":"Tamaoka","year":"1987","journal-title":"Int. J. Syst. Evol. Microbiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.clae.2015.09.001","article-title":"Assessment of biofilm formation of E. meningoseptica, D. acidovorans, and S. maltophilia in lens cases and their growth on recovery media","volume":"39","author":"Liu","year":"2016","journal-title":"Cont. Lens Anterior Eye"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"121","DOI":"10.4103\/jgid.jgid_66_22","article-title":"Delftia acidovorans: An Unusual Pathogen from an Adenocarcinoma Lung Patient with Pleural Effusion","volume":"15","author":"Lall","year":"2023","journal-title":"J. Glob. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1155\/2015\/973284","article-title":"Delftia acidovorans: A rare pathogen in immunocompetent and immunocompromised patients","volume":"26","author":"Bilgin","year":"2015","journal-title":"Can. J. Infect. Dis. Med. Microbiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/S2221-1691(12)60254-8","article-title":"Fatal Delftia acidovorans infection in an immunocompetent patient with empyema","volume":"2","author":"Khan","year":"2012","journal-title":"Asian Pac. J. Trop. Biomed."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1099\/00207713-49-2-567","article-title":"Phylogenetic relationships among members of the Comamonadaceae, and description of Delftia acidovorans (den Dooren de Jong 1926 and Tamaoka et al. 1987) gen. nov., comb. nov","volume":"49","author":"Wen","year":"1999","journal-title":"Int. J. Syst. Bacteriol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.jcf.2011.09.001","article-title":"MALDI-TOF MS improves routine identification of non-fermenting Gram negative isolates from cystic fibrosis patients","volume":"11","author":"Morosini","year":"2012","journal-title":"J. Cyst. Fibros."},{"key":"ref_9","unstructured":"The European Committee on Antimicrobial Susceptibility Testing (2025). Breakpoint Tables for Interpretation of MICs and Zone Diameters, Version 15.0, The European Committee on Antimicrobial Susceptibility Testing."},{"key":"ref_10","unstructured":"Clinical and Laboratory Standards Institute\u2014CLSI (2025). Performance Standards for Antimicrobial Susceptibility Testing, CLSI. [35th ed.]. CLSI Supplement M100."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"5673","DOI":"10.1128\/AAC.02984-14","article-title":"Microscopic and spectroscopic analyses of chlorhexidine tolerance in Delftia acidovorans biofilms","volume":"58","author":"Rema","year":"2014","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"49","DOI":"10.3341\/kjo.2008.22.1.49","article-title":"Experience of Comamonas acidovorans keratitis with delayed onset and treatment response in immunocompromised cornea","volume":"22","author":"Lee","year":"2008","journal-title":"Korean J. Ophthalmol."},{"key":"ref_13","first-page":"1559","article-title":"Infection of the orbita due to Delftia acidovorans after a cat scratch","volume":"145","author":"Smits","year":"2020","journal-title":"Dtsch. Med. Wochenschr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1007\/s00284-015-0818-6","article-title":"Characterization and Genomic Analysis of Quinolone-Resistant Delftia sp. 670 Isolated from a Patient Who Died from Severe Pneumonia","volume":"71","author":"Kang","year":"2015","journal-title":"Curr. Microbiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/S0163-4453(97)94199-2","article-title":"Broviac catheter-related bacteraemias due to unusual pathogens in children with cancer: Case reports with literature review","volume":"34","author":"Castagnola","year":"1997","journal-title":"J. Infect."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1097\/00006454-199610000-00021","article-title":"Vascular catheter-related Comamonas acidovorans bacteremia managed with preservation of the catheter","volume":"15","author":"Ender","year":"1996","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1097\/01.idc.0000155840.49633.f6","article-title":"Ochrobactrum anthropi and Delftia acidovorans to Bacteremia in a Patient With a Gunshot Wound","volume":"13","author":"Oliver","year":"2005","journal-title":"Infect. Dis. Clin. Pract."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/s10156-010-0089-x","article-title":"Recurrent vascular catheter-related bacteremia caused by Delftia acidovorans with different antimicrobial susceptibility profiles","volume":"17","author":"Kawamura","year":"2011","journal-title":"J. Infect. Chemother."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3418","DOI":"10.1128\/JCM.00625-11","article-title":"Recurrent intravascular-catheter-related bacteremia caused by Delftia acidovorans in a hemodialysis patient","volume":"49","author":"Chotikanatis","year":"2011","journal-title":"J. Clin. Microbiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e130","DOI":"10.1097\/INF.0000000000003818","article-title":"Delftia acidovorans: Rarely a Pathogen: A Case Report","volume":"42","author":"Agarwal","year":"2023","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e256439","DOI":"10.1136\/bcr-2023-256439","article-title":"Delftia acidovorans sepsis in a neonate with nosocomial pneumonia","volume":"16","author":"Alam","year":"2023","journal-title":"BMJ Case Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1128\/jcm.28.1.143-145.1990","article-title":"Endocarditis associated with Comamonas acidovorans","volume":"28","author":"Horowitz","year":"1990","journal-title":"J. Clin. Microbiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1007\/BF01690106","article-title":"Oerskovia turbata and Comamonas acidovorans bacteremia in a patient with AIDS","volume":"15","author":"Lair","year":"1996","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"73","DOI":"10.3844\/ajidsp.2005.73.74","article-title":"Delftia Acidovorans Bacteremia in an Intravenous Drug Abuser","volume":"1","author":"Perla","year":"2005","journal-title":"Am. J. Infect. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.jecm.2012.04.010","article-title":"Delftia acidovorans Bacteremia Associated with Ascending Urinary Tract Infections Proved by Molecular Method","volume":"4","author":"Kam","year":"2012","journal-title":"J. Exp. Clin. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1007\/s12088-011-0221-3","article-title":"Delftia acidovorans as an Unusual Causative Organism in Line-Related Sepsis","volume":"52","author":"Lang","year":"2012","journal-title":"Indian. J. Microbiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3799","DOI":"10.1128\/JCM.00553-12","article-title":"Acute infective endocarditis caused by Delftia acidovorans, a rare pathogen complicating intravenous drug use","volume":"50","author":"Mahmood","year":"2012","journal-title":"J. Clin. Microbiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1007\/s10156-012-0472-x","article-title":"Delftia acidovorans bacteremia caused by bacterial translocation after organophosphorus poisoning in an immunocompetent adult patient","volume":"19","author":"Hagiya","year":"2013","journal-title":"J. Infect. Chemother."},{"key":"ref_30","first-page":"1","article-title":"A Case of Sepsis by a Rare Pathogen Delftia acidovorans in a Patient Undergoing Chemotherapy","volume":"16","author":"Singh","year":"2022","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1016\/j.ajic.2022.08.007","article-title":"A cluster of gram-negative bloodstream infections in Connecticut hemodialysis patients associated with contaminated wall boxes and prime buckets","volume":"51","author":"Backman","year":"2023","journal-title":"Am. J. Infect. Control"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.2147\/IDR.S457781","article-title":"Retrospective Cohort Study on Delftia acidovorans Infections in Patients: A Rare and Significant Infection","volume":"17","author":"Lu","year":"2024","journal-title":"Infect. Drug Resist."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"4117","DOI":"10.1016\/j.biomaterials.2008.07.014","article-title":"Bacterial adhesion and growth on a polymer brush-coating","volume":"29","author":"Nejadnik","year":"2008","journal-title":"Biomaterials"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1002\/pbc.24482","article-title":"Central venous catheters and catheter locks in children with cancer: A prospective randomized trial of taurolidine versus heparin","volume":"60","author":"Handrup","year":"2013","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/S0272-6386(04)01078-9","article-title":"Dialysis catheter-related bacteremia: Treatment and prophylaxis","volume":"44","author":"Allon","year":"2004","journal-title":"Am. J. Kidney Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1177\/11297298211026453","article-title":"Taurolidine lock in the treatment of colonization and infection of totally implanted venous access devices in cancer patients","volume":"24","author":"Brescia","year":"2023","journal-title":"J. Vasc. Access"}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/14\/4\/365\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:08:12Z","timestamp":1760029692000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/14\/4\/365"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,1]]},"references-count":36,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["antibiotics14040365"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics14040365","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,1]]}}}