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）』「2015/02/15 21:55:20」(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 Staphyloccocus 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. PMID 25268440.

External links

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

Two Cases of Bacteremia Due to Roseomonas mucosa.

Kim YK1, Moon JS2, Song KE3, Lee WK2,4.
Annals of laboratory medicine.Ann Lab Med.2016 Jul;36(4):367-370. doi: 10.3343/alm.2016.36.4.367.
Roseomonas is a genus of pink-pigmented nonfermentative bacilli. These slow-growing, gram-negative cocobacilli form pink-colored colonies on sheep blood agar. They differ from other pink-pigmented nonfermenters, including Methylobacterium, in morphology, biochemical characteristics, and DNA sequence
PMID 27139611

Hepatitis C status and infectious complications in the surgical intensive care unit: a retrospective analysis of 1,941 consecutive patients.

Kueht M1, Bebko S2, Helmick R2, Awad S2.
American journal of surgery.Am J Surg.2016 Jun;211(6):1064-70. doi: 10.1016/j.amjsurg.2015.07.033. Epub 2015 Dec 13.
BACKGROUND: Hepatitis C virus (HCV) infection is thought to be associated with immune dysfunction. We hypothesized that HCV status would be associated with increased infectious complications in the surgical intensive care unit (SICU).METHODS: All patients admitted to our SICU between 2008 and 2012 w
PMID 26746567

Anaerobic bacteraemia: a 10-year retrospective epidemiological survey.

De Keukeleire S1, Wybo I2, Naessens A2, Echahidi F2, Van der Beken M2, Vandoorslaer K2, Vermeulen S3, Piérard D2.
Anaerobe.Anaerobe.2016 Jun;39:54-9. doi: 10.1016/j.anaerobe.2016.02.009. Epub 2016 Feb 23.
In order to identify current trends in anaerobic bacteraemia, a 10-year retrospective study was performed in the University Hospital Brussel, Belgium. All clinically relevant bacteraemia detected from 2004 until 2013 were included. Medical records were reviewed in an attempt to define clinical param
PMID 26923749

Japanese Journal

クレブシエラ肺炎桿菌による敗血症・髄膜脳炎に難治性眼内炎が併発した1例

太田雅彦,米田行宏,喜多美穂里 [他]
臨床神経学 53(1), 37-40, 2013-01-00
NAID 40019555222

Meningococcemia due to the 2000 Hajj-Associated Outbreak Strain (Serogroup W-135 ST-11) with Immunoreactive Complications

Yamamoto Kei,Kato Yasuyuki,Shindo Takuma,Ujiie Mugen,Takeshita Nozomi,Kanagawa Shuzo,Kunimatsu Junwa,Tamori Yuiichi,Kano Toshikazu,Okuno Rumi,Takahashi Hideyuki,Ohmagari Norio
Japanese Journal of Infectious Diseases 66(5), 443-445, 2013
… meningitidis bacteremia. …
NAID 130003381726

Functional Imbalance between Th17, Th1, and Treg Cells in A. actinomyctemcomitans -Accelerated Atherosclerosis

Jia Ru,Kurita-Ochiai Tomoko,Hashizume-Takizawa Tomomi,Kobayashi Ryoki,Yamamoto Masafumi
International Journal of Oral-Medical Sciences 12(1), 13-20, 2013
… We previously reported that Aggregatibacter actinomyctemcomitans（Aa）bacteremia accelerated atherosclerosis in apolipoprotein E-deficient spontaneously hyperlipidemic（Apoeshl）mice. …
NAID 130003375194

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