Bacteremia – pearls from Dr. Shams (VA)


  • 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.


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