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BLOOD CULTURE
Test CodeLAB462
CPT Codes
87040
Includes
Brucella, Fransicella, Leptospira, cell wall deficient species, and other unusual organisms may not be isolated by usual culture techniques. If these organisms are suspected, GBMC Microbiology must be notified in advance.
Instructions
Guidelines for Collection:
For suspected acute sepsis: draw 2 to 3 sets from separate sites within 10 minutes before antimicrobials if possible.
For fever of unknown origin: draw 2 to 4 sets one hour apart or longer. If negative at 24 hours, obtain 2 or 3 more sets.
For endocardititis: draw 3 sets 15 minutes apart or longer. If negative at 24 hours, obtain 2 or 3 more sets.
Collect multiple specimens at 30-60 minute intervals unless otherwise specified.
Ideal Skin Preparation
1. Cleanse first with 70-95% alcohol
2. Starting at the middle of the site, swab concentrically with chlorhexidine gluconate (recommended for infants 2 months and older)
3. Allow the antiseptic to dry for maximum effect
For suspected acute sepsis: draw 2 to 3 sets from separate sites within 10 minutes before antimicrobials if possible.
For fever of unknown origin: draw 2 to 4 sets one hour apart or longer. If negative at 24 hours, obtain 2 or 3 more sets.
For endocardititis: draw 3 sets 15 minutes apart or longer. If negative at 24 hours, obtain 2 or 3 more sets.
Collect multiple specimens at 30-60 minute intervals unless otherwise specified.
Ideal Skin Preparation
1. Cleanse first with 70-95% alcohol
2. Starting at the middle of the site, swab concentrically with chlorhexidine gluconate (recommended for infants 2 months and older)
3. Allow the antiseptic to dry for maximum effect
Setup Schedule
Set Up:Daily Report Available:5 days
Clinical Significance
The correct collection of blood cultures is essential for maximum recovery of pathogens responsible for bloodstream infections. Blood specimens should be collected before antimicrobial agents are administered. The optimal time for the collection of a blood culture is just before the anticipated onset of a chill. In most cases, this is difficult or impossible to predict reliably. Therefore, blood is typically collected after the onset of fever or chills. In medically urgent situations in which antimicrobial therapy is to be started immediately, it is advisable to make two separate blood collections within a few minutes and then start antimicrobial therapy. The determining factor is the clinical urgency of the situation and the need to collect samples before treatment begins. Although it is tempting for the patient care provider drawing the blood to collect a large volume of blood from a single venipuncture site and to inoculate it into two or more blood culture sets, it is imperative that the specimens be collected from two separate (i.e. opposite arms) sites whenever two or more specimens are obtained within a few minutes. Collection from a single site increases the risk of contamination in multiple blood cultures which could be misinterpreted by the physician. The total volume of blood procured for culture is a critical factor in the recovery of the potential bacterial pathogens. The current blood culture bottles used in Microbiology should be inoculated with 8-10 ml of blood. Smaller volumes may be used (appropriate in neonates), but will decrease the recovery rate of organisms. In most adult infections, a maximum of only two or three blood culture samples in the initial 24 hour period is needed for optimal recovery of pathogens. Patients with severe infections who are already receiving antimicrobial therapy may require additional blood cultures.
Performing Laboratory
GBMC Microbiology
