Bloodstream Infection

The “Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals” protocol adopts the following definition of Bloodstream Infection (BSI).

Laboratory-confirmed bloodstream infection (BSI)

one positive blood culture for a recognised pathogen

or

the patient has at least one of the following signs or symptoms: fever (> 38 °C), chills, or hypotension

and

two positive blood cultures for a common skin contaminant (from two separate blood samples, usually within 48 hours).

Skin contaminants are considered: coagulase-negative staphylococci (including S. epidermidis), Micrococcus spp., Propionibacterium acnes, Bacillus spp., Corynebacterium spp.

Sources of bloodstream infection are considered:

Catheter-related

the same microorganism was cultured from the catheter or symptoms improve within 48 hours after removal of the catheter (C-PVC: peripheral catheter, C-CVC: central vascular catheter)

Secondary to another infection

the same microorganism was isolated from another infection site, or strong clinical evidence exists that bloodstream infection was secondary to another infection site, invasive diagnostic procedure or foreign body:

• pulmonary (S-PUL);
• urinary tract infection (S-UTI);
• digestive tract infection (S-DIG);
• surgical site infection (S-SSI);
• skin and soft tissue (S-SST);
• other (e.g. meningitis, osteomyelitis, etc.) (S-OTH).

Unknown origin (UO)

none of the above, bloodstream infection of unknown origin (verified during survey and no source found)

Unknown (UNK)

no information available about the source of the bloodstream infection or information missing

Link to European IC/HH Core Competencies

• Area 3. Surveillance and investigation of healthcare-associated infection (HAI)

References

• http://www.ecdc.europa.eu/en/publications/Publications/0512-TED-PPS-HAI-antimicrobial-use-protocol.pdf
• Horan TC, Emori TG. Definitions of keyterms used in the NNIS system. AJIC AM J of Infect Control 1997;25:112-6