関: bacteraemic、bacteremia、bacteremic

WordNet

transient presence of bacteria (or other microorganisms) in the blood (同)bacteriemia, bacteriaemia
of or relating to or having bacteremia

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/01/14 17:29:14」(JST)

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Bacteremia (also bacteraemia) is the presence of bacteria in the blood. Blood is normally a sterile environment,^[1] so the detection of bacteria in the blood (most commonly accomplished by blood cultures) is always abnormal.

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).

Bacteremia can have several consequences. The immune response to the bacteria can cause sepsis and septic shock, which has a relatively high mortality rate. Bacteria can also use the blood to spread to other parts of the body (which is called hematogenous spread), causing infections away from the original site of infection. Examples include endocarditis or osteomyelitis. Treatment is with antibiotics, and prevention with antibiotic prophylaxis can be given in situations where problems are to be expected.

Definition

Bacteremia is the presence of viable bacteria in the blood stream. Bacteremia is different from sepsis (so-called blood poisoning or toxemia), which is a condition where bacteremia is associated with an inflammatory response from the body (causing systemic inflammatory response syndrome, characterised by rapid breathing, low blood pressure, fever, etc.). Common oral hygiene, such as brushing teeth or flossing, can cause transient but harmless bacteremia.^[2] Some patients with prosthetic heart valves however need antibiotic prophylaxis for dental surgery because bacteremia might lead to endocarditis (infection causing inflammation of the interior lining of the heart).

"Septicemia" is an ill-defined non-scientific term introducing more confusion between sepsis and bacteremia: it misleadingly suggests there is something in the bloodstream causing sepsis.

Causes

In the hospital, indwelling catheters are a frequent cause of bacteremia and subsequent nosocomial infections, because they provide a means by which bacteria normally found on the skin can enter the bloodstream. Other causes of bacteremia include dental procedures (occasionally including simple tooth brushing), herpes (including herpetic whitlow), urinary tract infections, peritonitis, Clostridium difficile colitis, intravenous drug use, and colorectal cancer. Bacteremia may also be seen in oropharyngeal, gastrointestinal or genitourinary surgery or exploration. Salmonella infection, despite mainly only resulting in gastroenteritis in the developed world, is a common cause of bacteremia in Africa. It principally affects children who lack antibodies to Salmonella and HIV+ patients of all ages.

Consequences

Bacteremia, as noted above, frequently elicits a vigorous immune system response. The constellation of findings related to this response (such as fever, chills, or hypotension) is referred to as sepsis. In the setting of more severe disturbances of temperature, respiration, heart rate or white blood cell count, the response is characterized as septic shock, and may result in multiple organ dysfunction syndrome.

Bacteremia is the principal means by which local infections are spread to distant organs (referred to as hematogenous spread). Bacteremia is typically transient rather than continuous, due to a vigorous immune system response when bacteria are detected in the blood. Hematogenous dissemination of bacteria is part of the pathophysiology of meningitis and endocarditis, and of Pott's disease and many other forms of osteomyelitis.

Diagnosis

Bacteremia is most commonly diagnosed by blood culture, in which a sample of blood is allowed to incubate with a medium that promotes bacterial growth. Since blood is normally sterile, this process does not normally lead to the isolation of bacteria. If, however, bacteria are present in the bloodstream at the time the sample is obtained, the bacteria will multiply and can thereby be detected. Any bacteria that incidentally find their way to the culture medium will also multiply. For this reason, blood cultures must be drawn with great attention to sterile process. Occasionally, blood cultures will reveal the presence of bacteria that represent contamination from the skin through which the culture was obtained. Blood cultures must be repeated at intervals to determine if persistent — rather than transient — bacteremia is present.

Ultrasound of the heart is recommended in all those with bacteremia due to Staphylococcus aureus to rule out infectious endocarditis.^[3]

References

^ Ochei; et al. "Pus Abscess and Wound Drain". Medical Laboratory Science : Theory And Practice. Tata McGraw-Hill Education, 2000. p. 622.
^ Forner L, Larsen T, Kilian M, Holmstrup P (2006). "Incidence of bacteremia after chewing, tooth brushing and scaling in individuals with periodontal inflammation". J Clin Periodontol 33 (6): 401–7. doi:10.1111/j.1600-051X.2006.00924.x. PMID 16677328.
^ Holland, TL; Arnold, C; Fowler VG, Jr (1 October 2014). "Clinical management of Staphylococcus aureus bacteremia: a review.". JAMA 312 (13): 1330–41. doi:10.1001/jama.2014.9743. PMID 25268440.

External links

Lowell S. Young,Bacteremia at the Merck Manuals Online Medical Library
Bacteremia at Medscape eMedicine

UpToDate Contents

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1. 成人におけるグラム陰性桿菌菌血症 gram negative bacillary bacteremia in adults
2. 成人における黄色ブドウ球菌菌血症に対する臨床的アプローチ clinical approach to staphylococcus aureus bacteremia in adults
3. 菌検出のための血液培養 blood cultures for the detection of bacteremia
4. 成人におけるA群レンサ球菌（Streptococcus pyogenes）性菌血症 group a streptococcal streptococcus pyogenes bacteremia in adults
5. 血管内カテーテル感染症治療 treatment of intravascular catheter related infections

English Journal

Nontyphoidal Salmonella infection in children: relation to bacteremia, age, and infecting serotype.

Asmar BI1,2, Abdel-Haq N1,2.
Infectious diseases (London, England).Infect Dis (Lond).2016 Feb;48(2):147-51. doi: 10.3109/23744235.2015.1094823. Epub 2015 Oct 12.
BACKGROUND: Salmonella gastroenteritis, usually self- limited, can result in bacteremia and focal disease. This study was undertaken to determine the role of age and infecting Salmonella serotype on the risk of bacteremia in children.METHODS: This was a review of medical records of children with pos
PMID 26458080

Infections on the rise: Raoultella spp., clinical and microbiological findings from a retrospective study, 2010-2014.

Boattini M1,2, Almeida A1,2, Cardoso C1, Cruz CS1, Machado C1, Vesza Z1, Tosatto V1, Maia D3, Cardoso S4, Pinto M5, Moura RB1,2, Garcia T1,2, Guerreiro AS1,2.
Infectious diseases (London, England).Infect Dis (Lond).2016 Jan;48(1):87-91. doi: 10.3109/23744235.2015.1082619. Epub 2015 Sep 11.
We performed a retrospective analysis of clinical and laboratory data over 5 years in a tertiary centre to assess clinical and microbiological characteristics of patients with Raoultella spp. infection. Raoultella spp. were deemed responsible for clinical infections in 57 patients (R. planticola, n
PMID 26357998

Predictors of shock and mortality in solid organ transplant recipients with bacteremia caused by non-lactose-fermenting gram-negative bacilli.

Wan Q1, Luo A2, Ye Q1,3, Liu S4, Zhou J5.
Infectious diseases (London, England).Infect Dis (Lond).2016 Jan;48(1):32-9. doi: 10.3109/23744235.2015.1051106. Epub 2015 Sep 2.
BACKGROUND: More data on bacteremia due to non-lactose fermenting gram-negative bacilli (NLF GNB) in solid organ transplant (SOT) recipients are needed. We aimed to investigate the epidemiology, microbiology, and risk factors for mortality and septic shock due to NLF GNB bacteremia in SOT recipients
PMID 26329287

Japanese Journal

Cefotaxime for the detection of extended-spectrum β-lactamase or plasmid-mediated AmpC β-lactamase and clinical characteristics of cefotaxime-non-susceptible Escherichia coli and Klebsiella pneumoniae bacteraemia.

Matsumura Y,Yamamoto M,Matsushima A,Nagao M,Ito Y,Takakura S,Ichiyama S
European journal of clinical microbiology & infectious diseases 31(8), 1931-1939, 2012-08-01
… We investigated the performance of cefotaxime for the detection of extended-spectrum β-lactamase (ESBL) or plasmid-mediated AmpC β-lactamase (pAmpC) and the clinical characteristics of cefotaxime-non-susceptible Escherichia coli or Klebsiella pneumoniae (CTXNS-EK) bacteraemia. … Patients with CTXNS-EK bacteraemia less frequently received appropriate empirical therapy than patients with cefotaxime-susceptible EK bacteraemia (81% vs. 97%, p<0.001) and died within 30 days (21% vs. 5%, p=0.001). …
NAID 120005312143

The Ecology, Biology and Pathogenesis of Acinetobacter spp. : An Overview

Doughari Hamuel James,Ndakidemi Patrick Alois,Human Izanne Susan [他],BENADE SPINNEY
Microbes and environments 26(2), 101-112, 2011-06-01
… The organisms are associated with bacteraemia, pulmonary infections, meningitis, diarrhea and notorious nosocomial infections with mortality rates of 20 to 60%. …
NAID 10029122539

Prediction of Patient Outcome from Acinetobacter baumannii Bacteremia with Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE) II Scores

Chen Su-Jung,Chao Tze-Fan,Chiang Mei-Chun,Kuo Shu-Chen,Chen Liang-Yu,Yin Ti,Chen Te-Li,Fung Chang-Phone
Internal Medicine 50(8), 871-877, 2011
… baumannii bacteraemia. …
NAID 130000650077