- Blood culture contamination: Only Coagulase negative Staphylococci, Bacillus species, and Corynebacteria can be attributed to blood culture contamination if they grow in 1/2 or 1/4 culture bottles with repeat blood cultures being negative and patient has no suspicious underlying hardware (ex: pacemakers, prosthetic heart valves, or joint prostheses).
- Need for 2-D Echos:
- Order a 2-D Echo to assess baseline cardiac function in all patients with true Gram positive bacteremia.
- Persistent bacteremia is having positive blood cultures that are drawn > 24 hours apart.
- Order 2-D Echo for all patients with persistent bacteremia (Gram positive or Gram negative).
- Order 2-D Echo for all cases of fungemia.
- Document clearance of bacteremia or fungemia with repeat blood cultures that remain negative before discharge.
- Simple, uncomplicated bacteremia is best treated with 2 weeks of IV antibiotic therapy – 2 weeks starts from the date of negative blood culture.
- Contult ID for ALL true bacteremia and fungemia.