Blood Stream

Infections (BSI)
A dive into
BSI's
Learning 
objectives 
 Definition
 Types 
 Signs & Symptoms 
 Causative agents

 Laboratory Diagnosis 

 Treatment
 What is BSI? 
 a blood stream infection (BSI) is defined as one or more positive blood
cultures associated with systemic signs of infection such as fevers,
chills and/or hypotension

Terminology of bsi's​
 Bacteremia: the presence of viable bacteria in blood without any
multiplication usually does not cause infection
 Septicemia: the presence and multiplication of bacteria or
toxins in blood
      DIFFERENCE BETWEEN
BACTERIMIA AND SEPTICEMIA
 Types of bsi
 Based on site of origin
 Primary BSI
 Secondary BSI

 Based on place of acquisition

 Nosocomial/Health care associated BSI
 Community acquired BSI
 Maternally acquired BSI
 How does it happen?
 Bacteria can enter the bloodstream as a severe complication of
infections (like pneumonia or meningitis), during surgery (especially
when involving mucous membranes such as the gastrointestinal tract),
or due to catheters and other foreign bodies entering the arteries or
veins (including during intravenous drug abuse)

 Bacteria can also enter the bloodstream when they penetrate tissue

barrier. In the bloodstream erythrocytes are the main bactericidal
cells . Entering the bloodstream, bacteria move with blood flow and
become electrically charged because of the phenomenon of
triboelectric friction charging
 Symptoms of bsi's
 Fast heart rate
 Low blood pressure
 Fever or hypothermia
 Shaking or chills
 Warm or sweaty skin
 Confusion or disorientation
 Shortness of breath
 Sepsis rash
 Extreme pain or discomfort
 Causative agents

Staphylococcus aureus
 E.coli
Staphylococcus epidermidis 
 Klebsiella pneumoniae
Streptococcus pneumoniae
 Pseudomonas aeruginosa
Enterococcus spp
 Salmonella
Group B streptococci
 Enterobacter spp
Streptococcus pyogenes
 Acinetobacter
Viridans streptococci
 Haemophilus influenzae
 Laboratory diagnosis
 Bacteremia can be diagnosed using a blood culture.

SPECIMEN COLLECTION.
• Blood culture specimens are usually drawn using either a needle and syringe or a
vacuum-extraction collection system that draws blood into vacuum-sealed blood culture
bottles.
 Laboratory di
Timing agnosis
• As early as possible, after the onset of clinical symptoms.
• Before starting antimicrobial therapy.

Blood volume

• Adult-10 ml per bottle.

• Pediatric – 1-5 ml per bottle.

Number of blood culture bottles.

• 2 blood culture set (1 set is equal to 1 aerobic and 

      1 anerobic bottle)
• Endocarditis –3 sets from 3 different sites within
      1-2 hours
 Treatment of
BSI's
 The treatment for a bloodstream infection requires prompt use of
antibiotics. 
 This can help to prevent complications like sepsis from occurring. 

 When bacteria are confirmed in your blood, you'll likely be started

on broad-spectrum antibiotics, typically via IV.

 The length of treatment can depend on the cause and severity of

the infection. You may need to be on antibiotics for 1 to 2 weeks.
IV fluids and other medications may also be given during treatment
to help stabilize your condition.