bacteremia

definitions of bacteremia

Diagnosis

• ≥2 sets BCx prior to → abx (set = aerobic + aneaerobic cx) at ↣ separate puncture sites
• If proven bacteremia,
  • daily surveillance cxs until 48 hrs of ⊖ cxs.
  • May not need for GNRs (ClD 2017;65:1776).
• if concern for endocarditis (see IE section)
  • TTE/TEE
• if yeast is → growing in BCx
  • TTE and
  • urgent ophthalmology evaluation

Treatment (CID 2009;49:1; JAMA 2020;323:2160)

• Empiric abx based on Gram stain, cx, & clinical syndrome, then → tailor based on sensitivities
• Short-Term Central Venous Catheter-Related Bloodstream Infxns
• Persistently ⊕ BCx: remove CVCs, look for metastatic infxn (endocarditis, septic arthritis, osteo), infected thrombosis, or prosthetic material (vascular graft, PPM)

實務上

Lab 報長 GBC in cluster/chain: 當下處理：先抽一對：再加 Teico/Vanc