Bacteria surround us all the time. There are a lot of them on the surface of the skin; conditionally pathogenic bacteria are also present in the intestines. In addition, they can enter the organs of the genitourinary, respiratory and other body systems. However, the most dangerous condition is the presence of bacteria in the bloodstream, or bacteremia (forumdisplay).
Main reasons
Bacteremia is a pathological process that can be caused by many different reasons, because there are a lot of ways of bacteria to enter the body. Most often, they enter the bloodstream for the following reasons:
- Violation of the rules of asepsis (preventing microorganisms from entering the sterile environment) and antiseptics (eliminating microorganisms where they may be) during surgical interventions.
- Long-term serious illnesses that require long-term injection interventions or mechanical ventilation. The prolonged presence of foreign objects in the human body increases the chances of bacteria entering the bloodstream.
- Secondary bacteremia in infections is a condition characterized by bacterial colonization of the bloodstream against an existing infection (gastrointestinal tract, respiratory system, urogenital system).
- A risk factor for the development of this condition is injecting drug addicts, as well as people with immunodeficiency (HIV-infected).
Thus, bacteremia is characteristic of people with weakened immunity and for those who have constantly impaired skin integrity.
Pathophysiology
Bacteremia is a condition that for a certain time may not cause any harm to the body. However, if this process has been observed for a long time, bacteria can migrate to any internal organ, forming a focus of infection and inflammation there. As a result of this, abscesses (purulent foci limited by the capsule) and phlegmon (diffuse purulent inflammation) are formed. The most dangerous damage to the brain and heart.
In addition, with damage to the valves and the inner lining of the heart (endocardium), a disease occurs called infectious endocarditis. This disease, with untimely diagnosis and treatment, causes the destruction of heart valves and leads to the development of heart failure.
Symptoms
As already noted above, bacteremia is a process that can be asymptomatic for a long time without causing any complaints to the patient. However, over time, it makes itself felt.
The following symptoms are most characteristic:
- violation of general health: severe fatigue, weakness;
- fever, accompanied by sweating and chills;
- dizziness and headache;
- heart rate and breathing;
- symptoms such as a drop in blood pressure and impaired consciousness can also indicate the development of septic shock.
Sepsis
Perhaps someone has the opinion that bacteremia and sepsis are two inextricable concepts, but this is not so. The first characterizes only the fact of the presence of bacteria in the body, while sepsis is already a more serious condition. And for making such a diagnosis, the following symptoms are necessary:
- body temperature above 38 ° C or below 36 ° C;
- palpitations of more than 90 beats per minute;
- respiratory rate greater than 20 cycles per minute;
- the number of leukocytes in the blood is more than 12 thousand / mm 3 or less than 4 thousand / mm 3;
- the presence of bacteria in the bloodstream during blood culture.
Although, according to recent studies, the presence of bacteria in the blood is no longer a mandatory criterion for sepsis. That is, simply put, sepsis is an excessive reaction of the body to infection.
Septic shock and multiple organ failure
Septic shock is considered as the next stage of sepsis, which is accompanied by a drop in systolic blood pressure below 90 mm RT. Art. Moreover, this hypotension is incapable of correction by infusion of saline solutions. This means that the function of the cardiovascular system is so disturbed that even an increase in the volume of circulating blood with the help of saline solutions cannot increase the pressure.
Multiple organ failure - this term refers to a violation of the function of almost all organs and systems of the body. It manifests itself in a decrease in the amount of urine released (oliguria), an even greater drop in blood pressure, respiratory depression, etc.
Thus, the concepts of bacteremia, septicemia and toxinemia are closely related. The presence of bacteria and their breakdown in the blood causes the accumulation of toxins (toxinemia), and these two conditions, in turn, lead to the development of septicemia.
Diagnostics
When a patient presents any of the complaints listed above, first of all, the doctor issues a referral for a general blood test. If this analysis confirms the presence of a bacterial infection in the body (an increased number of leukocytes - leukocytosis, mainly due to an increase in neutrophils - neutrophilia), the next step will be a bacteriological examination using blood culture to determine bacteremia.
In addition, if the presence of bacteria was detected during sowing, it is necessary to perform an x-ray of the organs of the chest cavity, an ultrasound examination of the chest and abdominal cavities, and organs of the small pelvis. These examination methods are necessary for the timely detection of purulent foci in the internal organs.
Treatment
Even before the results of blood culture, the patient with a suspected bacteremia is prescribed broad-spectrum antibiotics. Such therapy is called empirical. Based on the results of the sowing results (this may take several days), an antibiotic change is possible, depending on which drug the type of seeded bacteria is sensitive to.
As a rule, with a correctly selected antibiotic, health improves on the second day of therapy. However, antibiotic therapy should not be interrupted ahead of schedule prescribed by the attending physician.
In addition to antibiotics, symptomatic therapy is also needed to alleviate the condition of the patient:
- antipyretic at high temperature ("Paracetamol", "Ibuprofen");
- infusion of saline solutions at low blood pressure (isotonic sodium chloride solution, "Disol", "Acesol").
In the presence of purulent foci in the internal organs, surgical intervention is possible.
Bacteremia is a truly dangerous condition. When it is detected, it is necessary not only to eliminate the presence of bacteria in the bloodstream, but also to find out the root cause of their appearance and fight it.