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Overview :
Bloodstream infections can be primary or secondary.
Diagnosis can be made if an organism is identified in the laboratory or based
on clinical grounds.
Signs and Symptoms of
Bloodstream Infection
Signs and symptoms in patients > 12 months of age:
(1) fever ( > 38 °C)
(2) chills
(3) hypotension (systolic pressure <= 90 mm Hg)
(4) oliguria (< 20 mL/hr)
Signs and symptoms in patients <= 12 months of age:
(1) fever ( > 38 °C)
(2) apnea
(3) bradycardia
Clinical sepsis - all of the following:
(1) at least one of the signs and symptoms for age
(2) no other recognized cause for signs and symptoms
(3) at least one of the following:
(3a) blood culture not done or
(3b) no organism detected in blood
or
(3c) no antigen detected in blood
(4) no apparent infection at another site
(5) physician institutes appropriate antimicrobial therapy
for sepsis
Secondary bloodstream infection - both of the following
(1) recognized pathogen isolated from blood culture
(2) both of the following:
(2a) pathogen is not associated
with an intravascular device
(2b) pathogen causing infection at
another site
Laboratory-confirmed
Bloodstream Infection
Criteria 1:
(1) recognized pathogen isolated from blood culture
(2) at least one of the following:
(2a) pathogen is associated with
an intravascular device
(2b) pathogen not causing
infection at another site
Criteria 2:
(1) at least one of the signs and symptoms for age
(2) at least one of the following:
(2a) common skin
contaminant isolated on blood culture
isolated from 2 blood cultures drawn on separate occasions AND not related to
infection at another site
(2b) common skin
contaminant isolated on blood culture AND isolated from a patient with an
intravascular access device AND physician institutes appropriate antimicrobial
therapy
(2c) positive
antigen test on blood AND organism identified not related to infection at
another site
Common skin contaminants include:
(1) diphtheroids
(2) Bacillus species
(3) Proprionibacterium species
(4) coagulase negative staphylococcus
(5) Micrococcus species)
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