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class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Attiva/disattiva la sottosezione Clinica</span> </button> <ul id="toc-Clinica-sublist" class="vector-toc-list"> <li id="toc-Segni_e_sintomi" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Segni_e_sintomi"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1</span> <span>Segni e sintomi</span> </div> </a> <ul id="toc-Segni_e_sintomi-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Diagnosi" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Diagnosi"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2</span> <span>Diagnosi</span> </div> </a> <ul id="toc-Diagnosi-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Trattamento" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Trattamento"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Trattamento</span> </div> </a> <ul id="toc-Trattamento-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Note" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Note"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Note</span> </div> </a> <ul id="toc-Note-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Voci_correlate" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Voci_correlate"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Voci correlate</span> </div> </a> <ul id="toc-Voci_correlate-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Altri_progetti" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Altri_progetti"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Altri progetti</span> </div> </a> <ul id="toc-Altri_progetti-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Collegamenti_esterni" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Collegamenti_esterni"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>Collegamenti esterni</span> </div> </a> <ul id="toc-Collegamenti_esterni-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Indice" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" title="Indice" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Mostra/Nascondi l'indice" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Mostra/Nascondi l'indice</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Batteriemia</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Vai a una voce in un'altra lingua. Disponibile in 31 lingue" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-31" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">31 lingue</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%AA%D8%AC%D8%B1%D8%AB%D9%85_%D8%A7%D9%84%D8%AF%D9%85" title="تجرثم الدم - arabo" lang="ar" hreflang="ar" data-title="تجرثم الدم" data-language-autonym="العربية" data-language-local-name="arabo" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Bakterijemija" title="Bakterijemija - bosniaco" lang="bs" hreflang="bs" data-title="Bakterijemija" data-language-autonym="Bosanski" data-language-local-name="bosniaco" class="interlanguage-link-target"><span>Bosanski</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Bacteri%C3%A8mia" title="Bacterièmia - catalano" lang="ca" hreflang="ca" data-title="Bacterièmia" data-language-autonym="Català" data-language-local-name="catalano" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Bakteri%C3%A9mie" title="Bakteriémie - ceco" lang="cs" hreflang="cs" data-title="Bakteriémie" data-language-autonym="Čeština" data-language-local-name="ceco" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Bakteri%C3%A4mie" title="Bakteriämie - tedesco" lang="de" hreflang="de" data-title="Bakteriämie" data-language-autonym="Deutsch" data-language-local-name="tedesco" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-en mw-list-item"><a href="https://en.wikipedia.org/wiki/Bloodstream_infection" title="Bloodstream infection - inglese" lang="en" hreflang="en" data-title="Bloodstream infection" data-language-autonym="English" data-language-local-name="inglese" class="interlanguage-link-target"><span>English</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Bacteriemia" title="Bacteriemia - spagnolo" lang="es" hreflang="es" data-title="Bacteriemia" data-language-autonym="Español" data-language-local-name="spagnolo" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/Bakterieemia" title="Bakterieemia - estone" lang="et" hreflang="et" data-title="Bakterieemia" data-language-autonym="Eesti" data-language-local-name="estone" class="interlanguage-link-target"><span>Eesti</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Bakteriemia" title="Bakteriemia - basco" lang="eu" hreflang="eu" data-title="Bakteriemia" data-language-autonym="Euskara" data-language-local-name="basco" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Bakteremia" title="Bakteremia - finlandese" lang="fi" hreflang="fi" data-title="Bakteremia" data-language-autonym="Suomi" data-language-local-name="finlandese" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Bact%C3%A9ri%C3%A9mie" title="Bactériémie - francese" lang="fr" hreflang="fr" data-title="Bactériémie" data-language-autonym="Français" data-language-local-name="francese" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ha mw-list-item"><a href="https://ha.wikipedia.org/wiki/Cututtukan_jini" title="Cututtukan jini - hausa" lang="ha" hreflang="ha" data-title="Cututtukan jini" data-language-autonym="Hausa" data-language-local-name="hausa" class="interlanguage-link-target"><span>Hausa</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%96%D7%99%D7%94%D7%95%D7%9E%D7%99%D7%9D_%D7%91%D7%9E%D7%97%D7%96%D7%95%D7%A8_%D7%94%D7%93%D7%9D" title="זיהומים במחזור הדם - ebraico" lang="he" hreflang="he" data-title="זיהומים במחזור הדם" data-language-autonym="עברית" data-language-local-name="ebraico" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D4%B2%D5%A1%D5%AF%D5%BF%D5%A5%D6%80%D5%A5%D5%B4%D5%AB%D5%A1" title="Բակտերեմիա - armeno" lang="hy" hreflang="hy" data-title="Բակտերեմիա" data-language-autonym="Հայերեն" data-language-local-name="armeno" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Bakteremia" title="Bakteremia - indonesiano" lang="id" hreflang="id" data-title="Bakteremia" data-language-autonym="Bahasa Indonesia" data-language-local-name="indonesiano" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E8%8F%8C%E8%A1%80%E7%97%87" title="菌血症 - giapponese" lang="ja" hreflang="ja" data-title="菌血症" data-language-autonym="日本語" data-language-local-name="giapponese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%91%D0%B0%D0%BA%D1%82%D0%B5%D1%80%D0%B8%D0%B5%D0%BC%D0%B8%D1%8F" title="Бактериемия - kazako" lang="kk" hreflang="kk" data-title="Бактериемия" data-language-autonym="Қазақша" data-language-local-name="kazako" class="interlanguage-link-target"><span>Қазақша</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EA%B7%A0%ED%98%88%EC%A6%9D" title="균혈증 - coreano" lang="ko" hreflang="ko" data-title="균혈증" data-language-autonym="한국어" data-language-local-name="coreano" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Bacteri%C3%ABmie" title="Bacteriëmie - olandese" lang="nl" hreflang="nl" data-title="Bacteriëmie" data-language-autonym="Nederlands" data-language-local-name="olandese" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Bakteriemia" title="Bakteriemia - polacco" lang="pl" hreflang="pl" data-title="Bakteriemia" data-language-autonym="Polski" data-language-local-name="polacco" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Bacteremia" title="Bacteremia - portoghese" lang="pt" hreflang="pt" data-title="Bacteremia" data-language-autonym="Português" data-language-local-name="portoghese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Bacteriemie" title="Bacteriemie - rumeno" lang="ro" hreflang="ro" data-title="Bacteriemie" data-language-autonym="Română" data-language-local-name="rumeno" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%91%D0%B0%D0%BA%D1%82%D0%B5%D1%80%D0%B8%D0%B5%D0%BC%D0%B8%D1%8F" title="Бактериемия - russo" lang="ru" hreflang="ru" data-title="Бактериемия" data-language-autonym="Русский" data-language-local-name="russo" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%91%D0%B0%D0%BA%D1%82%D0%B5%D1%80%D0%B8%D1%98%D1%81%D0%BA%D0%B0_%D0%B8%D0%BD%D1%84%D0%B5%D0%BA%D1%86%D0%B8%D1%98%D0%B0_%D0%BA%D1%80%D0%B2%D0%B8" title="Бактеријска инфекција крви - serbo" lang="sr" hreflang="sr" data-title="Бактеријска инфекција крви" data-language-autonym="Српски / srpski" data-language-local-name="serbo" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Bakteriemi" title="Bakteriemi - svedese" lang="sv" hreflang="sv" data-title="Bakteriemi" data-language-autonym="Svenska" data-language-local-name="svedese" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-tg mw-list-item"><a href="https://tg.wikipedia.org/wiki/%D0%91%D0%B0%D0%BA%D1%82%D0%B5%D1%80%D0%B8%D0%B5%D0%BC%D0%B8%D1%8F" title="Бактериемия - tagico" lang="tg" hreflang="tg" data-title="Бактериемия" data-language-autonym="Тоҷикӣ" data-language-local-name="tagico" class="interlanguage-link-target"><span>Тоҷикӣ</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B8%A0%E0%B8%B2%E0%B8%A7%E0%B8%B0%E0%B9%80%E0%B8%A5%E0%B8%B7%E0%B8%AD%E0%B8%94%E0%B8%A1%E0%B8%B5%E0%B9%81%E0%B8%9A%E0%B8%84%E0%B8%97%E0%B8%B5%E0%B9%80%E0%B8%A3%E0%B8%B5%E0%B8%A2" title="ภาวะเลือดมีแบคทีเรีย - thailandese" lang="th" hreflang="th" data-title="ภาวะเลือดมีแบคทีเรีย" data-language-autonym="ไทย" data-language-local-name="thailandese" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Kan_dola%C5%9F%C4%B1m%C4%B1_enfeksiyonlar%C4%B1" title="Kan dolaşımı enfeksiyonları - turco" lang="tr" hreflang="tr" data-title="Kan dolaşımı enfeksiyonları" data-language-autonym="Türkçe" data-language-local-name="turco" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%91%D0%B0%D0%BA%D1%82%D0%B5%D1%80%D1%96%D1%94%D0%BC%D1%96%D1%8F" title="Бактеріємія - ucraino" lang="uk" hreflang="uk" data-title="Бактеріємія" data-language-autonym="Українська" data-language-local-name="ucraino" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Bakteriyemiya" title="Bakteriyemiya - uzbeco" lang="uz" hreflang="uz" data-title="Bakteriyemiya" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="uzbeco" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E8%A1%80%E6%B5%81%E6%84%9F%E6%9F%93" title="血流感染 - cinese" lang="zh" hreflang="zh" data-title="血流感染" data-language-autonym="中文" data-language-local-name="cinese" class="interlanguage-link-target"><span>中文</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a href="https://www.wikidata.org/wiki/Special:EntityPage/Q650912#sitelinks-wikipedia" title="Modifica collegamenti interlinguistici" class="wbc-editpage">Modifica collegamenti</a></span></div> </div> </div> </div> </header> <div class="vector-page-toolbar"> <div 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a.new:visited{color:#a55858}</style> <div class="hatnote noprint disclaimer"> <div class="hatnote-content"><span class="noviewer hatnote-icon" typeof="mw:File"><span><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f7/Nuvola_apps_important.svg/18px-Nuvola_apps_important.svg.png" decoding="async" width="18" height="15" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f7/Nuvola_apps_important.svg/27px-Nuvola_apps_important.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f7/Nuvola_apps_important.svg/36px-Nuvola_apps_important.svg.png 2x" data-file-width="600" data-file-height="500" /></span></span> <span class="hatnote-text">Le informazioni riportate non sono consigli medici e potrebbero non essere accurate. I contenuti hanno solo fine illustrativo e non sostituiscono il parere medico: <a href="/wiki/Wikipedia:Disclaimer_medico" title="Wikipedia:Disclaimer medico">leggi le avvertenze</a>.</span></div> </div> <p>La <b>batteriemia</b>, in senso stretto, è la presenza di <a href="/wiki/Batteri" class="mw-redirect" title="Batteri">batteri</a> nel sangue. La batteriemia asintomatica può verificarsi durante le normali attività quotidiane come l'<a href="/wiki/Igiene_orale" title="Igiene orale">igiene orale</a> e dopo procedure mediche minori. In una persona sana, queste infezioni clinicamente benigne sono transitorie e non causano ulteriori conseguenze. Tuttavia, quando i meccanismi di <a href="/wiki/Risposta_immunitaria" title="Risposta immunitaria">risposta immunitaria</a> falliscono o vengono sopraffatti, la batteriemia diventa un'infezione del flusso sanguigno che può evolvere in vari quadri clinici e viene differenziata come <a href="/wiki/Setticemia" class="mw-redirect" title="Setticemia">setticemia</a>. La batteriemia non trattata e clinicamente significativa progredisce verso la <a href="/wiki/Sindrome_da_risposta_infiammatoria_sistemica" title="Sindrome da risposta infiammatoria sistemica">sindrome da risposta infiammatoria sistemica</a>, setticemia, <a href="/wiki/Shock_settico" title="Shock settico">shock settico</a> e <a href="/wiki/Sindrome_da_disfunzione_multiorgano" title="Sindrome da disfunzione multiorgano">sindrome da disfunzione multiorgano</a>.<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:0_3-0" class="reference"><a href="#cite_note-:0-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Epidemiologia">Epidemiologia</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Batteriemia&veaction=edit&section=1" title="Modifica la sezione Epidemiologia" class="mw-editsection-visualeditor"><span>modifica</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Batteriemia&action=edit&section=1" title="Edit section's source code: Epidemiologia"><span>modifica wikitesto</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>La regione geografica, la popolazione dei pazienti, la resistenza ai farmaci e le pratiche di prevenzione delle infezioni in ciascuna istituzione influenzano gli organismi causali delle infezioni del flusso sanguigno. Considerando che i pazienti anziani con molteplici comorbilità sono più inclini a risiedere in centri comunitari e ad essere ricoverati in ospedale, non sorprende che siano a maggior rischio di sviluppare batteriemia. Tradizionalmente, i batteri gram-negativi erano la principale causa della maggior parte delle infezioni del flusso sanguigno nosocomiali negli Stati Uniti e sono ancora l'organismo più comune associato alla batteriemia acquisita in comunità. Tuttavia, con l'invecchiamento della popolazione e le procedure correlate ai dispositivi, i batteri aerobi gram-positivi hanno registrato un aumento nella prevalenza negli ultimi due decenni.<sup id="cite_ref-:0_3-1" class="reference"><a href="#cite_note-:0-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Eziologia">Eziologia</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Batteriemia&veaction=edit&section=2" title="Modifica la sezione Eziologia" class="mw-editsection-visualeditor"><span>modifica</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Batteriemia&action=edit&section=2" title="Edit section's source code: Eziologia"><span>modifica wikitesto</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Determinare la fonte primaria dell'infezione è cruciale nella gestione di un paziente con batteriemia, così come nell'identificazione della popolazione di pazienti interessata. Fonti comuni nei pazienti ospedalizzati includono l'apparato respiratorio e i cateteri permanenti, in particolare i cateteri venosi centrali. Le infezioni non trattate delle vie urinarie sono la causa più comune di batteriemia acquisita dalla comunità. Le infezioni dei tessuti molli e intraaddominali non sono altrettanto comuni e sono più diffuse nell'ambito chirurgico post-operatorio. Escherichia coli è la causa più comune di batteriemia associata a batteri gram-negativi, mentre Staphylococcus aureus è l'organismo gram-positivo più comune.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pubmed.ncbi.nlm.nih.gov_8-0" class="reference"><a href="#cite_note-pubmed.ncbi.nlm.nih.gov-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Fisiopatologia">Fisiopatologia</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Batteriemia&veaction=edit&section=3" title="Modifica la sezione Fisiopatologia" class="mw-editsection-visualeditor"><span>modifica</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Batteriemia&action=edit&section=3" title="Edit section's source code: Fisiopatologia"><span>modifica wikitesto</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Tutte le infezioni batteriche dipendono dal sistema immunitario dell'ospite, che è influenzato dalla loro firma genetica, nonché da carenze congenite ed acquisite. Le risposte immunitarie innate e adattative cellulari sono responsabili della rimozione iniziale dei microrganismi, mentre il fegato e la milza filtrano i batteri attivi nel sangue circolante. Nella sua forma più basilare, i batteri inizieranno a colonizzare la loro fonte primaria di localizzazione. In questo punto, i batteri possono diventare transitori e clinicamente insignificanti o possono sfuggire alla risposta immunitaria dell'ospite e aumentare in numero, diventando un'infezione locale che può alla fine migrare in altre parti del corpo. Se i batteri sono vitali ed entrano nel flusso sanguigno circolante, l'infezione può ancora risolversi spontaneamente o evolvere in setticemia. La prima barriera all'invasione batterica è la pelle e le superfici mucose. Le condizioni che interferiscono con queste barriere di difesa naturali includono comunemente procedure mediche che attraversano la pelle e le lumina anatomiche. Inoltre, eventi traumatici, ustioni, ulcere e gli effetti naturali dell'invecchiamento possono precipitare la rottura delle difese immunitarie.<sup id="cite_ref-pubmed.ncbi.nlm.nih.gov_8-1" class="reference"><a href="#cite_note-pubmed.ncbi.nlm.nih.gov-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Clinica">Clinica</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Batteriemia&veaction=edit&section=4" title="Modifica la sezione Clinica" class="mw-editsection-visualeditor"><span>modifica</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Batteriemia&action=edit&section=4" title="Edit section's source code: Clinica"><span>modifica wikitesto</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Segni_e_sintomi">Segni e sintomi</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Batteriemia&veaction=edit&section=5" title="Modifica la sezione Segni e sintomi" class="mw-editsection-visualeditor"><span>modifica</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Batteriemia&action=edit&section=5" title="Edit section's source code: Segni e sintomi"><span>modifica wikitesto</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>La presentazione classica in un paziente batteremico è la presenza di febbre. Non è necessario che si verifichino brividi e/o brividi; tuttavia, la presenza di tali segni dovrebbe far comprendere al medico che un paziente febbrile è ora batteremico. Lo sviluppo di setticemia che porta a sepsi e shock settico comporta comunemente ipotensione, alterazione dello stato mentale e diminuzione della produzione di urina dovuta all'ipovolemia causata dalla perdita di liquidi dai capillari. Man mano che l'infezione si diffonde, altri organi possono essere colpiti, causando la sindrome da distress respiratorio acuto e l'insufficienza renale acuta.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Diagnosi">Diagnosi</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Batteriemia&veaction=edit&section=6" title="Modifica la sezione Diagnosi" class="mw-editsection-visualeditor"><span>modifica</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Batteriemia&action=edit&section=6" title="Edit section's source code: Diagnosi"><span>modifica wikitesto</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Identificare o presumere la fonte dell'infezione determinerà le misure diagnostiche da adottare. Dovrebbe esserci una soglia bassa per richiedere esami di laboratorio e di imaging, poiché il tempo è essenziale per prevenire la setticemia. Nei pazienti presunti batteremici, i primi esami di laboratorio dovrebbero includere un livello di lattato e colture del sangue; idealmente, due serie di colture dovrebbero essere prese da ciascun braccio per valutare la presenza di organismi aerobici ed anaerobici. In ambiente ospedaliero, nella maggior parte dei pazienti, almeno, sarà necessario effettuare una radiografia del torace e un'analisi delle urine con coltura. Un paziente chirurgico potrebbe richiedere una tomografia computerizzata della zona della loro chirurgia per valutare la formazione di un ascesso o raccolta, nonché colture delle ferite per le infezioni del sito chirurgico. Allo stesso modo, un paziente intubato o che presenta una malattia polmonare richiederà colture delle secrezioni bronchiali. I pazienti con cateteri venosi permanenti, cateteri per l'emodialisi o port-a-cath dovrebbero avere i loro cateteri rimossi e i loro estremi sottoposti a coltura.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Trattamento">Trattamento</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Batteriemia&veaction=edit&section=7" title="Modifica la sezione Trattamento" class="mw-editsection-visualeditor"><span>modifica</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Batteriemia&action=edit&section=7" title="Edit section's source code: Trattamento"><span>modifica wikitesto</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>La batteriemia richiede antibiotici urgenti e appropriati. Un ritardo nell'administrazione di antibiotici appropriati è associato a un aumento della morbilità e della mortalità. Gli antibiotici empirici dovrebbero seguire un approccio logico basato sulla storia del paziente e sulla situazione attuale. Ad esempio, l'infezione è acquisita in comunità o in ospedale, qual è l'esposizione recente del paziente alle cure mediche, i trattamenti medici o chirurgici recenti e qual è la resistenza antibiotica locale? Prima che si finalizzi una colorazione di Gram, tutti i pazienti dovrebbero ricevere antibiotici ad ampio spettro che coprono batteri gram-positivi e gram-negativi, tra cui cefalosporine di ultima generazione o un inibitore della beta-lattamasi. La copertura per Pseudomonas è applicabile per la batteriemia acquisita in ospedale, così come per un paziente con recente esposizione alle cure mediche. Inoltre, la vancomicina dovrebbe essere aggiunta per coprire organismi gram-positivi resistenti, in particolare Staphylococcus aureus meticillino-resistente (MRSA). Quando il medico ottiene le colture definitive, gli antibiotici dovrebbero essere adattati alla terapia diretta a partire dalla colorazione di Gram e, alla fine, dalla suscettibilità agli antimicrobici. Non esiste una durata ottimale del trattamento. Nella maggior parte dei casi, il trattamento antibiotico dovrebbe continuare per sette-14 giorni e dovrebbe essere sempre somministrato per via parenterale. Gli agenti per via orale sono raccomandati quando i pazienti sono afebrili da almeno 48 ore e sono altrimenti clinicamente stabili.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Note">Note</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Batteriemia&veaction=edit&section=8" title="Modifica la sezione Note" class="mw-editsection-visualeditor"><span>modifica</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Batteriemia&action=edit&section=8" title="Edit section's source code: Note"><span>modifica wikitesto</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><a href="#cite_ref-1"><b>^</b></a> <span class="reference-text"><cite class="citation pubblicazione" style="font-style:normal"> Guillaume Butler-Laporte, Samuel De L'Étoile-Morel e Matthew P. Cheng, <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30102944/"><span style="font-style:italic;">MRSA colonization status as a predictor of clinical infection: A systematic review and meta-analysis</span></a>, in <span style="font-style:italic;">The Journal of Infection</span>, vol. 77, n. 6, 2018-12, pp. 489-495, <a href="/wiki/Digital_object_identifier" title="Digital object identifier">DOI</a>:<a rel="nofollow" class="external text" href="https://dx.doi.org/10.1016%2Fj.jinf.2018.08.004">10.1016/j.jinf.2018.08.004</a>. <small>URL consultato il 1º settembre 2023</small>.</cite></span> </li> <li id="cite_note-2"><a href="#cite_ref-2"><b>^</b></a> <span class="reference-text"><cite class="citation pubblicazione" style="font-style:normal"> Gabrielle Dagasso, Joslyn Conley e Elizabeth Parfitt, <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30156131/"><span style="font-style:italic;">Risk factors associated with bloodstream infections in end-stage renal disease patients: a population-based study</span></a>, in <span style="font-style:italic;">Infectious Diseases (London, England)</span>, vol. 50, n. 11-12, 2018, pp. 831-836, <a href="/wiki/Digital_object_identifier" title="Digital object identifier">DOI</a>:<a rel="nofollow" class="external text" href="https://dx.doi.org/10.1080%2F23744235.2018.1500707">10.1080/23744235.2018.1500707</a>. <small>URL consultato il 1º settembre 2023</small>.</cite></span> </li> <li id="cite_note-:0-3"><span class="mw-cite-backlink"><b>^</b> <sup><i><a href="#cite_ref-:0_3-0">a</a></i></sup> <sup><i><a href="#cite_ref-:0_3-1">b</a></i></sup></span> <span class="reference-text"><cite class="citation pubblicazione" style="font-style:normal"> Marc Arcens, Jérôme Stirnemann e Grégoire Mayor, <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30156786/"><span style="font-style:italic;">[Epidemiology and strategy to prevent urinary catheters related complications]</span></a>, in <span style="font-style:italic;">Revue Medicale Suisse</span>, vol. 14, n. 616, 29 agosto 2018, pp. 1518-1521. <small>URL consultato il 1º settembre 2023</small>.</cite></span> </li> <li id="cite_note-4"><a href="#cite_ref-4"><b>^</b></a> <span class="reference-text"><cite class="citation pubblicazione" style="font-style:normal"> Hannah Lishman, Céire Costelloe e Susan Hopkins, <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30145249/"><span style="font-style:italic;">Exploring the relationship between primary care antibiotic prescribing for urinary tract infections, Escherichia coli bacteraemia incidence and antimicrobial resistance: an ecological study</span></a>, in <span style="font-style:italic;">International Journal of Antimicrobial Agents</span>, vol. 52, n. 6, 2018-12, pp. 790-798, <a href="/wiki/Digital_object_identifier" title="Digital object identifier">DOI</a>:<a rel="nofollow" class="external text" href="https://dx.doi.org/10.1016%2Fj.ijantimicag.2018.08.013">10.1016/j.ijantimicag.2018.08.013</a>. <small>URL consultato il 1º settembre 2023</small>.</cite></span> </li> <li id="cite_note-5"><a href="#cite_ref-5"><b>^</b></a> <span class="reference-text"><cite class="citation pubblicazione" style="font-style:normal"> Alexa Dierig, Christoph Berger e Philipp K. 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Neuman e Christopher M. Pruitt, <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29784512/"><span style="font-style:italic;">Epidemiology and Etiology of Invasive Bacterial Infection in Infants ≤60 Days Old Treated in Emergency Departments</span></a>, in <span style="font-style:italic;">The Journal of Pediatrics</span>, vol. 200, 2018-09, pp. 210–217.e1, <a href="/wiki/Digital_object_identifier" title="Digital object identifier">DOI</a>:<a rel="nofollow" class="external text" href="https://dx.doi.org/10.1016%2Fj.jpeds.2018.04.033">10.1016/j.jpeds.2018.04.033</a>. <small>URL consultato il 1º settembre 2023</small>.</cite></span> </li> <li id="cite_note-9"><a href="#cite_ref-9"><b>^</b></a> <span class="reference-text"><cite class="citation web" style="font-style:normal">(<span style="font-weight:bolder; font-size:80%"><abbr title="inglese">EN</abbr></span>) <a rel="nofollow" class="external text" href="https://www.healthline.com/health/bacteremia"><span style="font-style:italic;">Bacteremia: Causes, Symptoms, and Treatments</span></a>, su <span style="font-style:italic;">Healthline</span>, 14 ottobre 2019. <small>URL consultato il 1º settembre 2023</small>.</cite></span> </li> <li id="cite_note-10"><a href="#cite_ref-10"><b>^</b></a> <span class="reference-text"><cite class="citation web" style="font-style:normal">(<span style="font-weight:bolder; font-size:80%"><abbr title="inglese">EN</abbr></span>) <a rel="nofollow" class="external text" href="https://my.clevelandclinic.org/health/diseases/25151-bacteremia"><span style="font-style:italic;">Bacteremia</span></a>, su <span style="font-style:italic;">Cleveland Clinic</span>. <small>URL consultato il 1º settembre 2023</small>.</cite></span> </li> <li id="cite_note-11"><a href="#cite_ref-11"><b>^</b></a> <span class="reference-text"><cite class="citation pubblicazione" style="font-style:normal"> Claudia R. 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Bhat e Abhay Kumar, <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30078972/"><span style="font-style:italic;">Bloodstream infections and trends of antimicrobial sensitivity patterns at Port Blair</span></a>, in <span style="font-style:italic;">Journal of Laboratory Physicians</span>, vol. 10, n. 3, 2018, pp. 332-337, <a href="/wiki/Digital_object_identifier" title="Digital object identifier">DOI</a>:<a rel="nofollow" class="external text" href="https://dx.doi.org/10.4103%2FJLP.JLP_50_18">10.4103/JLP.JLP_50_18</a>. <small>URL consultato il 1º settembre 2023</small>.</cite></span> </li> <li id="cite_note-15"><a href="#cite_ref-15"><b>^</b></a> <span class="reference-text"><cite class="citation pubblicazione" style="font-style:normal"> Alison B. Rapoport, Leah S. Fischer e Scott Santibanez, <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30018999/"><span style="font-style:italic;">Infectious Diseases Physicians' Perspectives Regarding Injection Drug Use and Related Infections, United States, 2017</span></a>, in <span style="font-style:italic;">Open Forum Infectious Diseases</span>, vol. 5, n. 7, 2018-07, pp. ofy132, <a href="/wiki/Digital_object_identifier" title="Digital object identifier">DOI</a>:<a rel="nofollow" class="external text" href="https://dx.doi.org/10.1093%2Fofid%2Fofy132">10.1093/ofid/ofy132</a>. <small>URL consultato il 1º settembre 2023</small>.</cite></span> </li> </ol></div> <div class="mw-heading mw-heading2"><h2 id="Voci_correlate">Voci correlate</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Batteriemia&veaction=edit&section=9" title="Modifica la sezione Voci correlate" class="mw-editsection-visualeditor"><span>modifica</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Batteriemia&action=edit&section=9" title="Edit section's source code: Voci correlate"><span>modifica wikitesto</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Batteriuria" title="Batteriuria">Batteriuria</a></li> <li><a href="/wiki/Tossiemia" title="Tossiemia">Tossiemia</a></li> <li><a href="/wiki/Viremia" title="Viremia">Viremia</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="Altri_progetti">Altri progetti</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Batteriemia&veaction=edit&section=10" title="Modifica la sezione Altri progetti" class="mw-editsection-visualeditor"><span>modifica</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Batteriemia&action=edit&section=10" title="Edit section's source code: Altri progetti"><span>modifica wikitesto</span></a><span class="mw-editsection-bracket">]</span></span></div> <div id="interProject" class="toccolours" style="display: none; 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