emDOCs - February 20, 2023 - By Mary E. Lewis; Shannon Burke
Reviewed by: Summer Chavez; Alex Koyfman; Brit Long; Marina Boushra
Key Points:
- Bacteremia has significant morbidity and mortality.
- High-risk factors for development of bacteremia include the presence of central venous catheter, discitis, vertebral osteomyelitis, spinal epidural abscess, acute non-traumatic native septic joint, meningitis, septic shock, and ventriculoatrial shunt infections.
- Rapid identification of potential bacteremia and the initiation of broad-spectrum antibiotics is important. In the ED, physicians should always treat empirically when bacteremia is suspected, even when the specific bacteria is not confirmed.
- Triage tools may be useful for identifying patients at risk for bacteremia, but clinical judgment should supersede these scores.
- Molecular models may be a useful adjunct to blood cultures for the rapid identification of pathogens and susceptibilities but are not always readily available.