title: Bloodstream infections in internal medicine.
abstract: Bloodstream infections (BSI) carry a heavy burden of morbidity and mortality in modern internal medicine wards (IMW). These wards are often filled with elderly subjects with several risk factors for BSI, such as multiple comorbidities, polypharmacy, immunosuppression, and indwelling devices. Diagnosing BSI in such a setting might require a high degree of suspicion, since the clinical presentation could be affected by underlying conditions and concomitant medications, which might delay the administration of an appropriate antimicrobial therapy, an event strongly and unfavorably influencing survival. Furthermore, selecting the appropriate antimicrobial therapy to treat these patients is becoming an increasingly complex task in which all possible benefits and costs should be carefully analyzed from patient and public health perspectives. Only a specialized, continuous, and interdisciplinary approach could really improve the management of IMW patients in an era of increasing antimicrobial resistance and complexity of care.
authors.affiliation: a Clinica Malattie Infettive, IRCCS AOU San Martino-IST, Università di Genova , Genova , Italy.
authors.forename: Valerio
authors.initials: V
authors.lastname: Del Bono
authors.affiliation: a Clinica Malattie Infettive, IRCCS AOU San Martino-IST, Università di Genova , Genova , Italy.
authors.forename: Daniele Roberto
authors.initials: DR
authors.lastname: Giacobbe
mesh_terms: D000367:Age Factors; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D002175:Candida / Q000302:isolation & purification; D003141:Communicable Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology*; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D019468:Disease Management; D005260:Female; D006760:Hospitalization; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007388:Internal Medicine; D008297:Male; D012307:Risk Factors; D013211:Staphylococcus aureus / Q000302:isolation & purification
chemical_list: D000890:Anti-Infective Agents
keywords: BSI; bloodstream infections; internal medicine; medical wards; sepsis