bacteremia Flashcards
presence of viable bacteria in the bloodstream
innate immune response
bloodstream infection ( bacteremia leading to sepsis)
innate immune response failure
anatomic lesions
turbulent cardiac blood flow
foreign material in the body
CAP most common site of bacteria origin
respiratory tract
urinary tract
intraabdominal infections
CAP most frequent isolated pathogens
e.coli
s.pneumonia
s. aureus
HAP
Intravascular catheter- related blood stream infections
short term <14 days
long term > 14 days
peripheral venous catheter
inserted into the veins of the forearm or the hand
short term
peripheral arterial catheter
shorter
monitor hemodynamic status
determine blood gas levels of critically ill patients
short term CVC
most common
majority pf all catheter related blood stream infections
Long term CVC
surgically implanted CVC (hickman)
provide vascular access to patients
catheter colonization
significant growth of >+ 1 microorganism in a quantitative or semiquantiive culture of the catheter tip, subcutaneous cath segment, or cath hub
cath related
bacteriemia or fungemia in a patient who has an intravascular device and > 1 positive blood culture result obtained from the peripheral vein, clinical manifestation of infection, and no apparent source for bloodstream infection
where does the does the INTravascular CRBSI emanate from?
hub, insertion site or both
persutaneoulsy inserted, non cuff catheters
CoNS
S.aureus
candida
Enteric gram neg bacilli
surgically implanted and peripheral inserted CVC
CoNS
enteric gram neg bacili
s.aureus
p. aeruginosa
short term cvc or AC
mild/ mod ill (no hypotension/ organ failure)
no fever= remove CVC and AC, culture tip and insert at new site
blood cx, 2 sets –> consider antimicrobial
short term cvc or AC
seriously ill (hypotension, hypo perfusion signs and symptoms of organ failure)
blood cx, 2 sets , remove CVC and AC, culture tip and insert at new site or exchange –>initiate therapy
short term cvc or AC
blood culture (-)
CVC and AC not cultured
if continued fever and no other source
remove and culture CVC and AC
short term cvc or AC
blood culture (-)
CVC and AC (-)
look for other source
short term cvc or AC
blood culture (-)
CVC and AC > 15 CFU
for s.aureus treat 5-7 days
monitor
repeat blood cx
short term cvc or AC
blood culture (+)
CVC and AC > 15 CFU
complicated
remove cath and treat w systemic abx for 4-6 weeks
6-8 weeks for osteomyelitis
short term cvc or AC
blood culture (-)
CVC and AC > 15 CFU
uncomplicated
CoNS
remove and treat systemic abx 5-7 days
if cath is retained: abx + lock therapy 10-14 days
short term cvc or AC
blood culture (-)
CVC and AC > 15 CFU
uncomplicated
s. aureus
remove cath and treat w systemic abx for >14 days
short term cvc or AC
blood culture (-)
CVC and AC > 15 CFU
uncomplicated
enterococcus
remove cath and treat w systemic abx for 7-14 days
short term cvc or AC
blood culture (-)
CVC and AC > 15 CFU
uncomplicated
GN bacili
remove cath and treat w systemic abx for 7-14 days
short term cvc or AC
blood culture (-)
CVC and AC > 15 CFU
uncomplicated
candidas
remove cath and treat with a anti fungal therapy for 14 days after the first negative blood cx
long term cath
complicated
tunnel infection, port access
remove CVC/P and trat w abx 7-10 days
long term cath
complicated
septic, thrombosis, endocarditis, osteomyelitis
remove CVC/P and treat with abx for 4-6 weeks
6-8 weeks for osteomyelitis
long term
uncomplicated
s. aureus
remove the infected cath and then treat with 4-6 weeks of anribicrobial
long term
uncomplicated
GN bacilli
remove cvc/p anf trat for 7-10days
long term
uncomplicated
candida
remove and treat with antifunal 14dasy
