Current management of bloodstream infections

Abstract

Bloodstream infection (BSI) is a frequent complication of invasive infections. The presence of bacteremia has therapeutic and prognostic implications. Here we review recent changes in the epidemiology, diagnosis and treatment of BSI (excluding candidemia). The evidence of the impact of healthcare-association in many community-onset episodes and the increase in drug-resistant pathogens causing BSI in the community and hospitals is reviewed. The emergence of molecular methods as an alternative tool for the diagnosis of BSI and novel aspects of clinical management, particularly of some multidrug-resistant organisms. Several quality indicators related to the diagnosis and management of bacteremia in hospitals are proposed.

Keywords::

• antimicrobial resistance
• bacteremia
• bloodstream infections
• community-acquired infections
• nosocomial infections
• sepsis

Financial & competing interests disclosure

The authors have received financial support for their research from the Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III – FEDER, Spanish Network for the Research in Infectious Diseases (REIPI RD06/0008). Jesús Rodríguez-Baño has been a consultant for Wyeth, Merck and Pfizer, has served as speaker for Wyeth, Merck, Pfizer, Astra-Zeneca and GlaxoSmithKline, and has received research support from Merck and Wyeth. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.