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Bacteremia results when bacteria multiply at a rate that exceeds removal by phagocytes. The clinical pattern of bacteremia may be transient, intermittent, or continuous. Transient bacteremia often occurs after manipulative procedures (dental procedures, cystoscopy) or surgery in contaminated areas of the body. Undrained abscesses (intraabdominal, pelvic, hepatic) may result in intermittent bacteremia. A hallmark feature of subacute bacterial endocarditis is a continuous bacteremia.
The sources of bacteremia are the genitourinary tract (25%), the respiratory tract (20%), abscesses (10%), surgical wounds (5%), the biliary tract (5%), other known sites (10%), and unknown sites (25%).
As a general guideline, 2 sets of cultures should be collected per febrile episode in adult patients, no more than 4 blood culture sets should be collected in a 24-hour period, and blood cultures should be collected prior to administration of antibiotics.
Identification of all organisms
Mandell GL, Bennett JE, Dolin R: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. Sixth edition. New York, Churchill Livingstone, 2005, pp 906-926