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CULTURE, BLOOD
Test CodeBC
CPT Codes
87040
Includes
Isolation and identification of both anaerobic and aerobic microorganisms and susceptibility testing on all significant aerobic isolates. If culture is positive, identification will be performed at additional charge (CPT code(s): 87150 x27, 87076, 87106, or 87077. Antibiotic susceptibilities are only performed when appropriate (CPT code(s): 87185 or 87186).
Preferred Specimen
8-10 mL blood per Bactec bottle (Aerobic & Anaerobic)
1-3 mL (Peds Plus)
1-3 mL (Peds Plus)
Patient Preparation
After location of the vein by palpation, the venipuncture site should be cleansed with 70% alcohol and then swabbed in a circular motion concentrically from the center outward using tincture of iodine or a povidone-iodine solution. The iodine should be allowed to dry before the venipuncture is undertaken. If palpation is required during the venipuncture, the glove covering the palpating finger tip should be disinfected. In iodine-sensitive patients, a double alcohol, green soap, or acetone alcohol preparation may be substituted.
Minimum Volume
Adult: 8-10 mL per bottle
Peds: 1-3 mL per bottle
Peds: 1-3 mL per bottle
Other Acceptable Specimens
SPS tube
Instructions
Blood cultures should be drawn prior to initiation of antimicrobial therapy. If more than one culture is ordered, the specimens must be drawn at separate intervals with time of collection indicated. A syringe and needle or transfer set can be used to collect the blood, aseptically clean top of the blood culture bottle with alcohol before specimen inoculation.
Transport Container
Bactec bottle - blue top (aerobic); Bactec bottle - yellow top (anaerobic)
Transport Temperature
Room Temperature, do not refrigerate. Transport to laboratory immediately.
Specimen Stability
Room temperature up to 24hrs
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Specimens not maintained at room temperature. Blood and bone marrow are the only acceptable sample types. Any other specimens will be rejected.
Methodology
BACTEC Continous Monitoring System
Setup Schedule
M, T, W, Th, F, Sa, Sun
Report Available
No growth (negative) culture will remain in process for 5 days with preliminary reports issued at 1 day and 2 days. If extended incubation is verbally requested, cultures may be held up to 4 weeks.
Positive cultures will be reported between 24-48 hours from initial setup and will be called as critical alerts.
Positive cultures will be reported between 24-48 hours from initial setup and will be called as critical alerts.
Limitations
Three negative sets of blood cultures in the absence of antimicrobial therapy are usually sufficient to exclude the presence of bacteremia. One set is seldom ever sufficient. Prior antibiotic therapy may cause negative blood cultures or delayed growth. Blood cultures from patients suspected of having Brucella must be requested as a special culture, contact laboratory. Yeast are often isolated from routine blood cultures; however, if yeast or other fungi are specifically suspected, a separate fungal blood culture should be draen along with each of the routine blood culture specimens. Mycobacterium avium-intracellulare (MAI) is frequently recovered from the blood of immunocompromised patients, particularly those with acquired immunodeficiency syndrome (AIDS). Special procedures are required for the recovery of these organisms, contact laboratory.
Reference Range
No growth
Performing Laboratory
Alverno Central Lab
Additional Information
Blood Collection Instructions
