Introduction:
Blood is commonly in a sterile environment. Bloodstream infections (BSI) occur when microorganisms from other body parts or an external source enter the blood and multiply. Bloodstream infections can be life-threatening and are the leading cause of morbidity and mortality. Various organisms can cause the infection, a common hospital-acquired infection. BSI can be followed by localized infections like UTI (urinary tract infection), endocarditis, pneumonia.
What Is Blood Streaming?
In a paranormal context or within certain belief systems, "blood streaming" might refer to the concept that blood possesses some form of energetic or spiritual significance. Some beliefs suggest that blood carries a person's essence, life force, or even connections to ancestral lines. In occult or mystical practices, blood rituals or ceremonies sometimes involve "blood streaming" where the act of drawing or using blood is seen as a means to harness power, make connections, or perform specific rituals.
What Is Meant by Bloodstream Infections (BSI)?
Bloodstream infections are diseases determined by bacteria, viruses, or fungi in the blood and positive blood cultures elicited by an inflammatory response such as fever, chills, or hypotension, recognized by alteration of clinical, hemodynamic, and laboratory parameters. BSI is categorized into three groups – occurring
In immunologically normal hosts with intact defenses.
In patients with physiological conditions impairing defenses (elderly, newborn).
In patients affected by pathological or pharmacological conditions predisposing to infections.
BSI is classified as hospital-acquired (HA), healthcare-associated (HCA), or community-acquired (CA) based on the site of acquiring infection and risk factors. CA-BSI can be separated from HA-BSI clinically in many factors, such as type of infection, pathogen distribution, and susceptibility patterns. For example, catheter-related infection and Staphylococcus were predominant in HA-BSI, while UTI and E. coli are predominant in CA-BSI.
Some common sources of bloodstream infections include:
Catheter-Related Infections: Infections occur when bacteria or fungi enter the bloodstream through intravenous catheters or central lines used for treatments or procedures.
Surgical Site Infections: Following surgery, bacteria can enter the bloodstream through the surgical site, leading to an infection.
Urinary Tract Infection: In some cases, bacteria from a urinary tract infection can spread to the bloodstream, causing bloodstream infection.
Pneumonia: Severe cases of pneumonia can result in bacteria entering the bloodstream, resulting in bloodstream infection.
What Are the Risk Factors for BSI?
Risk factors include:
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Immunocompromised conditions include HIV (human immunodeficiency virus) and cancers.
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Underlying illnesses such as UTI, meningitis, endocarditis, etc.
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In children with underdeveloped immune systems.
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ICU patients, long-term hospitalizations.
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Use of catheters or medical devices.
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Sepsis.
What Are the Symptoms of Bloodstream Infections?
The symptoms include:
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Fever.
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Fatigue.
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Stomach pain.
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Chills.
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Body aches.
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Rapid breathing.
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Low blood pressure.
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High heart rate.
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Rash.
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Confusion.
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Slurred speech.
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Pale skin.
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Extreme shivering.
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Muscle pain.
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Respiratory problems.
What Is Central Line-Associated Bloodstream Infection (CLABSI)?
A central line is a central venous catheter placed in a large vein in the neck, chest, or groin to give fluids or medications or collect blood for medical tests. Central lines differ from intravenous catheters (IV) that are used to give medication or fluids into a vein near the skin’s surface because central lines are placed into large or major veins close to the heart and kept for weeks or months and are likely to cause severe infections.
CLABSI is a serious infection due to the invasion of microorganisms into the bloodstream through central lines. Proper care should be taken while inserting catheters, and a strict protocol should be followed to keep the catheters sterile to prevent CLABSI.
Patients with CLABSI present with fever, redness of the skin, and soreness around the central line. When these symptoms are observed, the healthcare provider should perform a test to look for any presence of infection.
What Are the Steps Taken by Healthcare Providers to Prevent CLABSI?
The measures taken to prevent CLABSI include:
Following central line insertion practices recommended to prevent infection while placing a catheter–
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Hand hygiene.
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Applying appropriate antiseptic.
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Before inserting the catheter, ensure the skin prep agent is completely dried.
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Use sterile barriers such as gloves, gown, mask, cap, and large drape.
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Once the catheter is in place-
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Follow recommended practices for catheter maintenance.
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Washing hands with water and soap or alcohol hand rub before and after touching the catheter.
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Remove the catheter immediately if it is no longer needed to reduce the risk of infection.
How Does Bacteria Get in the Blood?
When an infection occurs in any part of the body, bacteria from that site can invade the bloodstream. For instance, a severe skin infection, urinary tract infection, pneumonia, or an abscess can allow bacteria to enter the bloodstream. Certain medical procedures, like surgeries, injections, or the insertion of catheters or IV (Intravenous) lines, can introduce bacteria directly into the bloodstream if proper sterile techniques are not followed.
Dental procedures or even routine activities like brushing teeth can allow bacteria from the mouth to enter the bloodstream. However, the body's defense mechanisms typically manage this. Severe injuries, especially those that puncture the skin, can lead to the introduction of bacteria into the bloodstream. Certain conditions, such as a compromised immune system or chronic illnesses, can make a person more susceptible to bacterial invasion into the bloodstream.
What Are the Associated Complications of Bloodstream Infections?
Bacteremia:
Bloodstream infections can be asymptomatic and occur in normal daily activities such as conducting oral hygiene and after minor medical procedures such as bacteremia. Failure to the immune response mechanism, bacteremia becomes a bloodstream infection. Clinically significant and untreated bacteremia leads to systemic inflammatory response syndrome (SIRS), septic shock, sepsis, and multiple organ dysfunction syndrome (MODS). Other complications include - meningitis, endocarditis, sepsis, cellulitis, osteomyelitis, and peritonitis.
Sepsis:
Sepsis is an extreme body response to any infection due to a chain reaction throughout the body. The infection that results in sepsis begins in the lungs, skin, gastrointestinal tract, or urinary tract. Not being treated on time can lead to tissue damage, organ failure, and death.
The symptoms include– high heart rate or weak pulse, disorientation or confusion, pain or discomfort, fever, shivering or chills, shortness of breath, and sweaty or clammy skin. Sepsis is a medical emergency, and immediate medical care is needed in an ICU (intensive care unit), monitoring vital signs and often antibiotics.
How to Diagnose Bloodstream Infections?
The diagnosis includes
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Physical or Clinical Findings– Fever, low blood pressure, increased heart rate, difficulty breathing.
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Laboratory Tests: Diagnosing bloodstream infections depends on the positivity of one or more blood cultures. Blood cultures to look for bacterial or viral infections like COVID-19 or influenza.
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Molecular tests for gram-positive and gram-negative tests are done.
What Is the Treatment?
Treatment of bloodstream infections includes
Antibiotics: Antibiotics prevent sepsis. Broad-spectrum antibiotics are used to treat BSI.
Maintenance of blood flow to vital organs of the body.
Surgery may be required to remove damaged tissue due to infection.
Conclusion:
Bloodstream infection can occur as a community-acquired or hospital-acquired infection and is a serious complication. BSI can be a primary infection or secondary to any other underlying medical condition such as endocarditis, UTI (Urinary tract infections), meningitis. It is associated with risk factors such as immunocompromised patients, ICU patients with central lines, long-term hospitalization, or due to minor surgical procedures. The diagnosis is based on clinical findings and blood cultures. Immediate treatment in the ICU, antibiotic therapy, and monitoring vitals are required. Precautions such as using sterile catheters, gloves, gowns, masks, and frequent hand wash or alcohol hand rub help prevent infection
