The major site of infection is a bloodstream infection and the specific site is either laboratory confirmed BSI or clinical sepsis. For example, a patient with leukemia with a vascular catheter has two positive blood cultures with coagulase negative staphylococci. Even if there are clinical signs and symptoms of localized infection at the vascular access site, but no other infection can be found, the infection is considered a primary bloodstream infection. Also, when a vascular access device is present and no other infection site is evident, then the BSI is considered a primary BSI regardless of whether there are localized signs of infection at the vascular access site.