Bacteremia

What is Bacteremia

Bacteremia is the presence of bacteria in the blood. When bacteria enter the bloodstream, they can cause a life-threatening reaction called sepsis, which is a medical emergency.

Bacteremia can spread to other parts of the body, including the heart, joints, and brain.

3 Interesting Facts of Bacteremia

1. As bacteremia is a laboratory diagnosis, the main differential diagnosis is between true bacteremia and blood culture contamination
2. Presence of MRSA is usually (and should be) regarded as true bacteremia, regardless of number of bottles 
3. MRSE is commonly a contaminant; features that suggest true MRSE bacteremia include: 
   • At least 2 bottles from different sets of blood cultures are positive
   • Blood culture becomes positive within 16 hours
   • Species is Staphylococcus epidermidis
   • Central venous catheter or prosthetic heart valve is present
   • Neutropenia is present
   • Severity of illness is high (as measured by Pitt or Charlson scores)

What are the causes?

This condition is caused by bacteria that get into the blood. Bacteria can enter the blood:

• From a skin infection or a cut on your skin.
• During an episode of pneumonia.
• From an infection in your stomach or intestine (gastrointestinal infection).
• From an infection in your bladder or urinary system (urinary tract infection).
• During a dental or medical procedure.
• After you brush your teeth so hard that your gums bleed.
• When a bacterial infection in another part of the body spreads to the blood.
• Through a dirty needle.

What increases the risk?

This condition is more likely to develop in:

• Children.
• Elderly adults.
• People who have a long-lasting (chronic) disease or medical condition.
• People who have an artificial joint or heart valve.
• People who have heart valve disease.
• People who have a tube, such as a catheter or IV tube, that has been inserted for a medical treatment.
• People who have a weak body defense system (immune system).
• People who use IV drugs.

What are the symptoms?

Symptoms of this condition include:

• Fever.
• Chills.
• A racing heart.
• Shortness of breath.
• Dizziness.
• Weakness.
• Confusion.
• Nausea or vomiting.
• Diarrhea.

In some cases, there are no symptoms. Bacteremia that has spread to the other parts of the body may cause symptoms in those areas.

How is this diagnosed?

This condition may be diagnosed with a physical exam and tests, such as:

• A complete blood count (CBC). This test looks for signs of infection.
• Blood cultures. These look for bacteria in your blood.
• Tests of any tubes that you may have inserted into your body, such as an IV tube or urinary catheter. These tests look for a source of infection.
• Urine tests including urine cultures. These look for bacteria in the urine that could be a source of infection.
• Imaging tests, such as an X-ray, CT scan, MRI, or heart ultrasound. These look for a source of infection in other parts of the body, such as the lungs, heart valves, or joints.

How is this treated?

This condition may be treated with:

• Antibiotic medicines given through an IV infusion. Depending on the source of infection, antibiotics may be needed for several weeks. At first, an antibiotic may be given to kill most types of blood bacteria. If your test results show that a certain kind of bacteria is causing problems, the antibiotic may be changed to kill only the bacteria that are causing problems.
• Antibiotics taken by mouth.
• IV fluids to support the body as you fight the infection.
• Removing any catheter or device that could be a source of infection.
• Blood pressure and breathing support, if you have sepsis.
• Surgery to control the source or spread of infection, such as:
  • Removing an infected implanted device.
  • Removing infected tissue or an abscess.

This condition is usually treated at a hospital. If you are treated at home, you may need to come back for medicines, blood tests, and evaluation. This is important.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic, take it as told by your health care provider. Do notstop taking the antibiotic even if you start to feel better.
• Rest until your condition is under control.
• Drink enough fluid to keep your urine clear or pale yellow.
• Do notsmoke. If you need help quitting, ask your health care provider.

Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

• Get the vaccinations that your health care provider recommends.
• Clean and cover any scrapes or cuts.
• Take good care of your skin. This includes regular bathing and moisturizing.
• Wash your hands often.
• Practice good oral hygiene. Brush your teeth two times a day and floss regularly.

Get help right away if:

• You have pain.
• You have a fever.
• You have trouble breathing.
• Your skin becomes blotchy, pale, or clammy.
• You develop confusion, dizziness, or weakness.
• You develop diarrhea.
• You develop any new symptoms after treatment.

Summary

• Bacteremia is the presence of bacteria in the blood. When bacteria enter the bloodstream, they can cause a life- threatening reaction called sepsis.
• Children and elderly adults are at increased risk of bacteremia. Other risk factors include having a long-lasting (chronic) disease or a weak immune system, having an artificial joint or heart valve, having heart valve disease, having tubes that were inserted in the body for medical treatment, or using IV drugs.
• Some symptoms of bacteremia include fever, chills, shortness of breath, confusion, nausea or vomiting, and diarrhea.
• Tests may be done to diagnose a source of infection that led to bacteremia. These tests may include blood tests, urine tests, and imaging tests.
• Bacteremia is usually treated with antibiotics, usually in a hospital.

Bacteremia, Pediatric

Bacteremia is the presence of bacteria in the blood. Bacteria in the blood may cause serious reactions throughout the body, and it can cause a life-threatening reaction called sepsis.

What are the causes?

This condition is caused by bacteria that get into the blood. Bacteria can enter the blood:

• From a skin infection or a cut on the skin.
• During an episode of pneumonia.
• From an infection:
  • In the stomach or intestines (gastrointestinal infection).
  • In the bladder or urinary system (urinary tract infection).
• During a dental or medical procedure.
• After brushing teeth so hard that the gums bleed.
• When a bacterial infection in another part of the body spreads to the blood.
• Through a dirty (contaminated) needle.

What increases the risk?

Your child is more likely to have this condition if she or he has:

• A long-lasting (chronic) medical condition.
• An artificial joint or heart valve.
• Heart valve disease.
• A tube that is inserted for a medical treatment, such as a catheter or an IV.
• A weak disease-fighting system (immune system).

What are the signs or symptoms?

Symptoms of this condition include:

• Fever.
• Weakness.
• Lack of energy.
• Chills.
• Fast heartbeat.
• Shortness of breath.
• Dizziness.
• Confusion.
• Nausea or vomiting.
• Diarrhea.

In some cases, there are no symptoms.

How is this diagnosed?

This condition may be diagnosed based on:

• A physical exam and medical history.
• Blood tests to check for bacteria (cultures) or other signs of infection (complete blood count, CBC).
• Tests of any tubes inserted in your child’s body. Testing is done to check for a source of infection.
• Urine tests, including urine cultures. These check for bacteria in the urine that could be a source of infection.
• Imaging tests, such as an X-ray, CT scan, MRI, or heart ultrasound. These tests check for a source of infection in other parts of the body, such as the lungs, heart valves, or joints.

How is this treated?

This condition is usually treated at a hospital. If your child is treated at home, he or she may need to return to the hospital for medicines, blood tests, and evaluation. Treatment may include:

• Antibiotic medicines given through an IV. Depending on the source of infection, your child may need antibiotics for several weeks. At first, an antibiotic may be given to destroy most types of blood bacteria. If your child’s test results show that a certain kind of bacteria is causing problems, the antibiotic may be changed to destroy only the bacteria that are causing problems.
• Antibiotics given by mouth (oralantibiotics).
• IV fluids to support your child’s body as he or she fights the infection.
• Removing any catheter or device that could be a source of infection.
• Blood pressure and breathing support, if your child has sepsis.
• Surgery to control the source or the spread of infection. This may involve:
  • Removing an infected implanted device.
  • Removing infected tissue or emptying a swollen area that contains pus (abscess).

Follow these instructions at home:

• Give your child take over-the-counter and prescription medicines only as told by your child’s health care provider.
• If your child was prescribed an antibiotic, give it as told by your child’s health care provider. Do notstop giving the antibiotic even if your child starts to feel better.
• Have your child rest at home.
• Have your child drink enough fluid to keep his or her urine pale yellow.

Keep all follow-up visits as told by your child’s health care provider. This is important.

How is this prevented?

• Make sure your child gets vaccinations as recommended by his or her health care provider.
• Take good care of your child’s skin. This includes:
  • Cleaning and covering any scrapes or cuts.
  • Having your child bathe and moisturize on a regular basis.
• Have your child wash his or her hands often. Wash your hands often as well.
• Help your child practice good mouth care (oral hygiene). This includes brushing teeth two times a day and flossing regularly.

Contact a health care provider if:

• Your child’s symptoms get worse, and medicines do not help.
• Your child has a fever.
• Your child has severe pain.

Get help right away if:

• Your child has trouble breathing.
• Your child’s skin becomes blotchy, pale, or clammy.
• Your child is confused.
• Your child is dizzy or he or she faints.
• Your child has chest pain.

Summary

• Bacteremia is the presence of bacteria in your child’s blood. This condition can cause serious reactions throughout the body, and it can cause a life-threatening reaction called sepsis.
• Bacteremia is usually treated at a hospital with antibiotic medicines, which may be given through an IV or by mouth.
• If your child was prescribed an antibiotic, give it as told by your child’s health care provider. Do notstop giving the antibiotic even if your child starts to feel better.