Pyrexia - PACT - ESICM

Task 2. Determining the cause of fever in the critically ill patient
negative staphylococci [including S.
epidermidis], viridans group
streptococci, Aerococcus spp.,
Micrococcus spp.) cultured from two or
more blood cultures drawn on separate
occasions
Criterion 3
Patient 38 C core) hypothermia (15
CFU and
Clinical signs of systemic sepsis
improve within 48 hours after
catheter removal.
Criterion 3 (CRI 3)
Blood stream infection (BSI)
occurring 48 hours before or after
catheter removal
and
Positive culture with the same microorganism
of either:
Quantitative CVC culture 10 3 CFU/ml
or
Semi-quantitative CVC culture >15
CFU or
Pus from the insertion site
Alternatively, if paired blood samples
are taken from blood and from the
CVC:
Quantitative blood culture ratio CVC
blood sample/peripheral blood
sample >5 or
Differential delay to positivity of
blood cultures: CVC blood sample
culture becomes positive 2 hours or
more before peripheral blood culture
(blood samples drawn at the same
time)
* Centers for Disease Control
**Hospitals in Europe Link for Infection Control through Surveillance
Causative micro-organisms include coagulase-negative staphylococci, S. aureus,
Enterococcus, Gram-negative and Candida spp. The following references
describe these criteria and preventable risk factors for infection.
[20]