Bacteremia

Bacteremia is the presence of bacteria in the blood. Bacteria is normally not present in the blood. Bacteria in the blood can indicate an infection and also spread the infection to other parts of the body. Bacteremia can be a dangerous condition that causes tissue damage, sepsis, and septic shock. If bacteremia is not treated, it can lead to organ damage and death. 

Patients should be protected from improper care that introduces bacteria to the body. Once the patient’s blood becomes infected with bacteria, bacteremia should be properly diagnosed and treated. Failure to provide proper care can lead to sepsis and septic shock. Individuals who suffer an injury due to bacteremia may have a claim for medical malpractice. Family members who lose a loved one to a bacterial infection may have a wrongful death claim. 

Bacteria in the Blood

Bacteria that are present in the bloodstream can occur from a number of sources. Bacteremia can occur spontaneously, with tissue infection, or medical procedures. The use of an intravenous catheter or genitourinary catheter can introduce bacteria into the blood. Unsanitary conditions during surgery, dental care, wound care, or gastrointestinal procedures can also introduce bacteria. 

Bacteremia can cause metastatic infection of the meninges or serous cavities. Metastatic infection can lead to metastatic abscesses, which may be more common in staph bacteremia. Patients with structural heart disease or prosthetic heart valves may be more predisposed to endocarditis caused by bacteremia. 

The circulatory system spreads oxygenated blood throughout the body and to all tissues and organs. When bacteria is introduced into the bloodstream, the bacteria can spread throughout the body. This can cause bacterial infections in different body parts, including: 

• Meningitis in brain tissue
• Pericarditis in the sac around the heart
• Endocarditis in the cells lining the heart valves
• Osteomyelitis in the bones
• Infection arthritis in the joints

If the bacteremia is not treated, it can lead to sepsis. Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Sepsis can cause problems with the circulatory system, leading to septic shock. Septic shock involves an abnormal distribution of blood supply to the smallest blood vessels. When there is an inadequate blood supply to the major organs and body tissues, it can lead to ischemia (restriction in blood supply to tissues), organ damage, and death. 

Signs and Symptoms of Bacteremia

The signs and symptoms of bacteremia can vary greatly from patient to patient. Many people are asymptomatic or only have a mild fever with bacteremia. As the symptoms worsen, it can be a sign that the patient may be septic or going into septic shock. Some signs and symptoms of bacteremia may include: 

• Rapid breathing rate
• Shaking
• Chills
• Fever
• Altered mental state
• Low blood pressure
• Abdominal pain
• Nausea 
• Vomiting
• diarrhea

Diagnosing of bacteremia is generally done with cultures of the blood. Blood tests may also indicate the type of bacteremia and suggest the proper treatment options. 

Treating Bacteremia

Treating bacteremia generally involves the use of antibiotics. Antibiotic treatment may start with broad-spectrum antibiotics. Antibiotics can also be more targeted to treat the specific infection or bacteria. Delayed use of antibiotics can lead to sepsis, septic shock, and death. 

Bacteremia may also require identifying the source of the initial infection and any infected tissues. If bacteremia was suspected from use of a catheter, the catheter should be removed. Any infected tissue may also need to be drained or removed. 

How Patients Get Bacteremia in the Hospital

In a hospital or healthcare facility, exposure to bacteria can result in hospital-acquired bacteremia or healthcare-associated bacteremia. Hospital acquired infections (HAI), or nosocomial infections, are one of the most common adverse events in healthcare. Some of the most common hospital acquired infections include: 

• MRSA (Methicillin-resistant Staphylococcus aureus)
• Staph Infection (Staphylococcus aureus)
• VAP (Ventilator-associated pneumonia)
• UTI (urinary tract infection)
• Gastroenteritis
• Puerperal Fever
• Legionnaires’ Disease
• Vancomycin-Resistant Enterococcus
• Tuberculosis
• E Coli
• C Diff (Clostridium difficile)
• S. Maltophilia
• A. Baumannii
• P. Aeruginosa
• Yeast Infections

 Healthcare facility acquired infections can come from improper cleaning procedures, contaminated surfaces, or not properly sanitizing surgical instruments. Even bacteria in the air ducts can be spread throughout a nursing care facility, spreading dangerous bacteria like Legionnaires’ disease.

Catheter-Associated Infection Bacteremia

Catheter-associated infections are not uncommon in healthcare settings. Some patients need an IV catheter inserted in order to receive regular administrations of medicine and fluids. An immediate introduction of bacteria into the blood can follow the placement of a catheter. 

Alternatively, over time, there may be an increased risk of bacteria developing at the site of the catheter. This is because bacteria may be more likely to collect on any artificial material present in the body, such as a catheter. This can be released into the bloodstream and cause bacteremia. 

The Infectious Disease Society of America (IDSA) has guidelines for catheter removal after bacteremia from the IV catheter. Short term catheters, those in place less than 14 days, should be removed if bacteremia is caused by: 

• Gram negative bacteria
• Staph infection
• Enterococci
• Fungi
• Mycobacteria

For patients with long-term catheters (more than 14 days), the catheter should be removed if the patient is developing signs of severe sepsis, suppurative thrombophlebitis, endocarditis, or if the blood cultures remain positive for more than 72 hours. 

Bacteremia and Medical Malpractice

Bacteremia and the septic shock associated with bacteremia may have been caused by negligence or medical malpractice. Medical malpractice and bacteremia can involve negligently causing the infection, failing to identify the infection, or failing to properly treat the infection. A doctor could also be found to have committed malpractice by failing to properly warn patients about the risk of infection. 

Causing the Infection

A bacterial infection can be caused as a direct result of medical care. When providing wound treatment or surgical care, doctors should be making sure they are following sanitization procedures, including washing hands, using sterilized equipment, and maintaining a sterile environment. Failure to provide proper care could introduce bacteria directly to the blood of a vulnerable patient. 

Failing to Identify, Diagnose, or Treat the Infection

Quickly identifying and treating bacteremia before it develops into sepsis, severe sepsis, or septic shock can improve the outcomes for patients. Negligence in a doctor’s failure to identify the signs and symptoms of bacteremia, delayed diagnosis, or failure to properly treat the infection could all increase the risk of serious damage as a result of bacteremia.

Informed Consent About the Risk of Infection

Medical professionals generally need to obtain informed consent from the patient before performing surgery or medical operations. Failure to obtain informed consent that results in harm or injury can be a type of medical malpractice. 

Bacteremia and Medical Malpractice Attorneys

Bacteremia and septic infection can cause serious tissue and organ damage. If you or a loved one suffered an injury related to bacteremia after medical care, talk to an experienced medical malpractice attorney about holding the doctor and hospital accountable for their negligence. Do not hesitate to contact Gilman & Bedigian today for a free consultation.