Basics pp 61-67 | Cite as

Prevention of Bloodstream Infections

  • Hendrick K. F. van Saene
  • Kentigern Thorburn
  • Andy J. Petros
Part of the Anaesthesia, Intensive Care and Pain in Neonates and Children book series (AICPNC)


Bloodstream infections occur from various sources. Certain microorganisms thrive in different parts of the body or colonize exogenous prosthetic pieces of equipment. Hence the source of a bloodstream infection can almost be predicted according to the microorganism detected. Coagulase-negative staphylococci (CNS) are in general associated with catheter-related bloodstream infections, whereas aerobic Gram-negative bacilli (AGNB) cause bloodstream infections following lymph drainage from the respiratory tract, intraabdominal space and urinary tract. Most bloodstream infections of unknown origin are gut-derived, e.g., fungemia following translocation of Candida albicans present as overgrowth in the gut. Table 6.1 shows that the contaminated catheter and the lower airways are leading causes of bloodstream infections [1–4].


Septic Shock Severe Sepsis Systemic Inflammatory Response Syndrome Bloodstream Infection Moraxella Catarrhalis 
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  1. 1.
    Pittet D, Tarara D, Wenzel RP (1994) Nosocomial bloodstream infection in critically ill patients. Excess length of stay, extra costs, and attributable mortality. JAMA 271:1598–1601CrossRefPubMedGoogle Scholar
  2. 2.
    Rello J, Ricart M, Mirelis B et al (1994) Nosocomial bacteremia in a medical-surgical intensive care unit: epidemiologic characteristics and factors influencing mortality in 111 episodes. Intensive Care Med 20:94–98CrossRefPubMedGoogle Scholar
  3. 3.
    Edgeworth JD, Treacher DF, Eykyn SJ (1999) A 25 year study of nosocomial bacteremia in an adult intensive care unit. Crit Care Med 27:1421–1428CrossRefPubMedGoogle Scholar
  4. 4.
    Valles J, Ochagania A, Rue M et al (2000) Critically ill patients with community-acquired bacteremia: characteristics and prognosis. Intensive Care Med 26[Suppl 3]:222Google Scholar
  5. 5.
    Brun-Buisson C, Doyon F, Carlet J (1996) Bacteremia and severe sepsis in adults: a multicenter prospective study in ICUs and wards of 24 hospitals. French Bacteremia-Sepsis Study Group. Am J Respir Crit Care Med 154:617–624PubMedGoogle Scholar
  6. 6.
    Valles J, Leon C, Alvarez-Lerma F (1997) Nosocomial bacteremia in critically ill patients: a multicenter study evaluating epidemiology and prognosis. Spanish Collaborative Group for Infections in Intensive Care Units of Sociedad Espagnola de Medicina Intensiva y Unidades coronanas (SEMIUC). Clin Infect Dis 24:387–395PubMedGoogle Scholar
  7. 7.
    Thorburn K, Taylor N, Lopez-Rodriguez L et al (2005) High mortality of invasive pneumococcal disease compared with meningococcal disease in critically ill children. Intensive Care Med 31:1550–1557CrossRefPubMedGoogle Scholar
  8. 8.
    Silvestri L, Petros AJ, Sarginson RE et al (2005) Handwashing in the intensive care unit: a big measure with modest effects. J Hosp Infect 59:172–179CrossRefPubMedGoogle Scholar
  9. 9.
    Silvestri L, van Saene HKF, Milanese M et al (2005) Impact of selective decontamination of the digestive tract in fungal carriage and infection: systematic review of randomised controlled trials. Intensive Care Med 31:898–910CrossRefPubMedGoogle Scholar
  10. 10.
    Silvestri L, van Saene HKF, Milanese M et al (2007) Selective decontamination of the digestive tract reduces bacterial bloodstream infection and mortality in critically ill patients. Systematic review of randomised, controlled trials. J Hosp Infect 65:187–203CrossRefPubMedGoogle Scholar
  11. 11.
    Ho KM, Rochford JA, Dobb GJ (2005) The use of topical non-absorbable gastro-intestinal antifungal prophylaxis to prevent fungal infections in critically ill immunocompetent patients: a meta-analysis. Crit Care Med 33:2383–2392CrossRefPubMedGoogle Scholar
  12. 12.
    Sarginson RE, Taylor N, Reilly N et al (2004) Infection in prolonged pediatric critical illness: a prospective four-year study based on knowledge of the carrier state. Crit Care Med 32:839–847CrossRefPubMedGoogle Scholar
  13. 13.
    Hanna H, Raad I (2002) Nosocomial infections related to use of intravascular devices inserted for long-term vascular access. In: Mayhall CG (ed) Hospital epidemiology and infection control, 3rd edn. Lippincott Williams and Wilkins, Philadelphia, pp 241–251Google Scholar
  14. 14.
    Bhutta A, Gilliam G, Honeycutt M et al (2007) Reduction of bloodstream infections associated with catheters in a paediatric intensive care unit: stepwise approach. BMJ 334:362–365CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2009

Authors and Affiliations

  • Hendrick K. F. van Saene
    • 1
  • Kentigern Thorburn
    • 2
  • Andy J. Petros
    • 3
  1. 1.Department of Medical Microbiology/Infection ControlRoyal Liverpool Children’s NHS Trust Alder Hey HospitalLiverpoolUK
  2. 2.Department of Paediatric Intensive CareRoyal Liverpool Children’s HospitalAlder Hey, LiverpoolUK
  3. 3.Paediatric Intensive Care Unit“Great Ormond Street” Children’s Hospital - PICULondonUK

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