Blood Culture

Blood Culture for Yeast order C B
Blood Culture for AFB/TB/Mycobacterium or MAI refer to C BAFB
Blood Culture for systemic mould (fungus) refer to C BLF

C B

Describe the TYPE OF BLOOD COLLECTION if known, such as: Blood-Peripheral, Blood-Central Line, Blood-Placental. May add additional source information such as Right arm, Red Lumen, Blood-Arterial, Blood-Broviac, White Lumen
Adult:
Bottle Type: Plus+Aerobic/F fill 8ml - 10ml
Bottle Type: Lytic/10 Anaerobic/F fill - 8ml - 10ml
Pediatrics:
Bottle Type: Peds Plus/F fill - 1ml - 3ml
Bottle Type: Lytic/10 Anaerobic/F fill based on patient weight - see information below for details
 

A complete routine culture set consists of both an aerobic and an anaerobic bottle. Preferred volumes of 8-10 ml should be adhered to for optimal results for adults and pediatrics >80lb.
If less than the required amount of blood has been obtained from an adult, see the below chart for recommended distribution of blood per bottle. NOTE: No more than 5 ml should be put in a PEDS bottle.

Total blood	Instructions
<0.5 ml	Redraw the patient
0.5-3 ml	Place in PEDS bottle if unable to redraw
3-5ml	Aerobic bottle only
6 ml	3 ml aerobic	3 ml anaerobic
7 ml	3 ml aerobic	4 ml anaerobic
8 ml	3 ml aerobic	5 ml anaerobic
9 ml	4 ml aerobic	5 ml anaerobic
10 ml	4 ml aerobic	6  ml anaerobic
11 ml	5  ml aerobic	6  ml anaerobic
12ml	5  ml aerobic	7  ml anaerobic
13ml	6  ml aerobic	7  ml anaerobic
14ml	6  ml aerobic	8  ml anaerobic
15ml	7  ml aerobic	8  ml anaerobic
16ml	7  ml aerobic	9  ml anaerobic
17ml	8  ml aerobic	9  ml anaerobic
18ml	8  ml aerobic	10  ml anaerobic
19ml	9  ml aerobic	10  ml anaerobic
20ml	10  ml aerobic	10  ml anaerobic

NOTE:  The volume of blood is critical because the concentration of organisms in the majority of bacteremias is low, especially if the patient is on antimicrobial therapy.   In children and infants, the concentration of organisms is higher than in adults, therefore less blood is required for culture.

Pediatrics (under age 7)** The maximum allowable volume collected is dependent upon the patient’s weight.  Withdraw the obtainable amount of blood, up to 10 ml per culture, from patients weighing 80 pounds or less. If >4 ml is collected, split specimen into PEDS and ANAEROBIC bottles inoculating the PEDS bottle first.  No more than 5 ml should be put in a PEDS bottle.  Note: For neonates in the Banner hospital setting, refer to nursing protocols for skin preparation or refer to your hospital-specific addendum.

If less than 2 ml of blood is drawn, only a PEDS bottle should be inoculated.

** For patients older than 7, drawing guidelines for adult patients may be used.

Below is the recommended distribution of blood per culture/per bottle type for cultures from infants and children by weight.

Within 30 minutes is optimal; within 2 hours is acceptable.
Any samples for routine blood culture received in blood culture bottles or transport vials other than those suitable for Bactec instrument processing, will be processed by a manual method with approval from the Microbiology department.

Plus+Aerobic bottle
Lytic/10 Anaerobic bottle
Peds Plus/F bottle

Ambient / Room Temperature

Transport to the laboratory AS SOON AS POSSIBLE. 
Within 30 minutes is optimal; within 2 hours is acceptable. 
Any samples for routine blood culture received in blood culture bottles or transport vials other than those suitable for Bactec instrument processing, will be processed by a manual method with approval from the Microbiology department.

Unacceptable specimens:
A specimen received in an inappropriate container (e.g. vacutainer tube without blood culture broth media).
Chipped, cracked or leaking vials will not be processed. Recollection will be requested immediately.
Specimens >24 hrs old

Negative

The presence of microorganisms in the blood can have serious effects on all the organs of the body.  The effects include fever, chills, malaise, tachycardia, hyperventilation, prostration, multiple organ failures, disseminated intravascular coagulation, septic shock, and death.

The detection of microorganisms in a patient's blood has importance in the diagnosis and prognosis of endocarditis, septicemia, or chronic bacteremia.

NOTE: due to the sensitivity of this culture good aseptic technique is needed during collection to avoid a false-positive result from skin commensal bacteria.