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Healthcare is full of similar terms describing related events in the human body. However, these terms often have different implications to those in the know. Bacteremia vs sepsis is one of these situations. Although the differences are not evident at first glance, the implications are serious and could be life threatening. It is important for all healthcare workers to be able to make this important distinction. With proper understanding, healthcare professionals can properly manage and treat those with these conditions.
What Are Bacteremia And Sepsis?
Bacteremia and sepsis both refer to bacteria and blood, but there are key differences between the two conditions. Let us first look at the definitions of each.
What Is Bacteremia?
This term refers to bacteria present in a person's blood. It says nothing as to how much bacteria is present, nor anything about the state of that bacteria. So, when a small amount of bacteria ends up in the blood after one brushes their teeth, for example, this is considered bacteremia. A major infection that floods a body with bacteria and leaks into the bloodstream is also considered bacteremia. Most of the time, there is only a small amount of bacteria which is quickly nullified and excreted. However, since this term can also refer to serious infections, more terminology is required.
What Is Sepsis?
When the body reacts to bacteria in the blood, symptoms arise such as a fever, rapid pulse and respirations, weakness, and confusion. This is called sepsis and is the result of massive amounts of inflammatory chemicals being released to react to the bacteria. Along with the symptoms, sepsis also has serious consequences as it has an effect on internal organs, such as the heart, lungs, and kidneys. As sepsis progresses, these organs begins to fail. This is why sepsis is a serious condition and also why there is much focus on this term.
What Is Septicemia?
There is one more term related to bacteremia vs sepsis. While bacteremia is bacteria in the blood stream, septicemia is the term used when these bacteria have begun to multiply. This is a much more serious condition than bacteremia, and will generally lead to sepsis. Septicemia can also be referred to as a blood infection. However, in practice, this term is less commonly used.
Here is one way to look at bacteremia vs sepsis vs septicemia: when bacteria are in the bloodstream, this is called bacteremia. When the bacteria have infected the blood and are growing, this is septicemia. When the bacteria cause enough of an effect to cause the body's immune system to react ferociously, then this is sepsis.
Is There A Need For Different Terms?
All of these terms describe a different medical condition, so bacteremia and sepsis are required. However, there is a difference between medical terminology and communicating with patients. When speaking with other healthcare professionals, specific terminology is required to convey exactly what is occurring within a patient's body. For this to work, all healthcare workers require schooling and training that covers the precise definitions in play. The public does not have this training, yet still need to understand their diseases. So, healthcare professionals may have to describe diseases in different ways.
What Causes The Confusion Between Bacteremia Vs Sepsis?
The confusion between bacteremia vs sepsis comes from how these conditions are commonly described to patients. When people have sepsis, healthcare professionals often describe this as bacteria in the blood or a blood infection. This simplified definition is essentially the same as bacteremia or septicemia. However, this is followed with an explanation as to why this is bad and why it requires immediate treatment. This is really the important information in terms of the patient's health and the information that must be properly understood.
In order to prevent patients from being confused by complicated definitions, all of these terms are boiled down to the basics, and conditions are usually referred to as sepsis. Doctors will say something like this to patients, "Bacteria is in your blood and this is very bad. It needs to be killed or else it could be life threatening." Although this is a simplification, the key information is conveyed to the patient.
How Is Sepsis Treated?
Sepsis is a serious condition that results in over 250,000 deaths a year. For this reason, treatment requires powerful medications. Intravenous antibiotics are commonly used, as well as broad-spectrum antibiotics that kill all types of bacteria. Once the particular bacteria has been identified through a blood culture or other testing, then doctors often switch to a more specific antibiotic. Intravenous fluids are also commonly used within three hours. These treatments usually require patients to be admitted into a hospital, which allows medical staff to constantly monitor their condition.
How Is Bacteremia Treated?
Bacteremia, on the other hand, usually only involves a small amount of bacteria in the blood. This is quickly eliminated by the body's immune system. Because it only stays in the body a short time, no treatment is required. Of course, bacteremia is the first step towards septicemia and potential complications such as septic shock. Also, it is not a specific term and could refer to serious infections. However, understanding bacteremia vs sepsis is that bacteremia conditions usually resolve without medical care while sepsis requires major medical care.
Even though most bacteremia is quickly resolved, there are several medical conditions healthcare professionals should be on the lookout for. First, when patients have a urinary catheter, bacteremia can occur if there is a urinary tract infection. Although this is a common cause, any catheter in a patient's body can cause bacteremia. Also, even if sepsis does not occur, conditions such as endocarditis or meningitis can occur with repeated bacteremia. In these cases, bacteremia is treated with antibiotics as soon as it is detected.
What Is Septic Shock?
One serious complication that can occur with sepsis is septic shock. In the life threatening condition, a patient's blood pressure drops and insufficient amounts of blood flow to the organs. This is how organs begin to fail, and this can result in mortality rates of up to 40% is severe cases. This can occur in those with compromised immune systems as well as those with functioning immunity. The key to treating this condition and preventing mortality is early detection and treatment.
Treatment Of Septic Shock
Like sepsis, antibiotics are required, but other treatments are also key. Vasopressors are often used to raise a patient's blood pressure, keeping mean arterial pressure over 65 mm Hg. Surgery may be performed to remove pus or infected tissue. Oxygen is often provided to patients as well as any machines necessary to support organ systems that no longer function. Methylene blue can also have beneficial effects. Finally, there are multiple stages of fluid replacement used for septic shock.
In this first phase, large amounts of fluids are given to patients to attempt to correct the low blood pressure. This is often done with vasopressor treatment and the two treatments need to be balanced. The sooner this begins for septic shock patients, the greater the chance of survival. However, patients must be constantly monitored to prevent them from being overload with fluids.
In this phase, the focus is on making sure that the tissues of the body are receiving a sufficient amount of oxygen. Fluids alone are often not enough, so blood transfusions may be used to increase the oxygen carrying capacity of blood. This can be measured by the hemoglobin in the blood. Having patients breathe supplemental oxygen can also help increase the amount of oxygen supplied to tissues.
When patients reach this stage, their bodies begin to recover from the septic shock. Fluids may no longer be required and vasopressor treatment may be stopped. Patients will still be carefully monitored to be sure that enough fluids are entering tissues as well as all vitals and organ functions. If any more fluids or treatment are required, they can be administered. However, this is only if necessary in this phase.
In this phase, a patient's body has recovered to the point that the excess fluids added during the fluid replacement treatment can actually be more of a problem. So, these excess fluids must be removed. Diuretic medications are often used if a patient does not adequately remove the excess fluid on their own. Healthcare professionals carefully monitor various markers to guide this phase.
Understanding the differences for bacteremia vs sepsis are important for all healthcare professionals. Though a simplified explanation may be sufficient for patients, it is useful for healthcare workers to understand the subtle differences between these terms. Also, even though sepsis requires aggressive treatment while bacteremia generally does not, there are cases where bacteremia alone can be harmful to patients even without progression. Of course, septic shock is a condition to avoid due to its high mortality. With proper understanding of these terms, healthcare workers can provide the best care.