Blood Culture

Notify laboratory. Specimens are generally drawn by phlebotomy personnel.

Draw times are specified by attending physician.

- Endocarditis, acute:  3 sets from 3 sites over a 1 to 2 hour period.

- Endocarditis, subacute:  3 sets from 3 sites drawn >15 minutes apart. If negative at 24 hours, draw 3 more sets. If specimens drawn ≥1 hour apart are negative, draw 2 to 3 more sets.

The 3 sets should be drawn within a 24-hour period, yield beyond this time is minimal.

- Sets drawn from pediatric patients may require assistance of a physician.

- If serial cultures are ordered, always draw at least first specimen prior to starting antibiotics.

- Preliminary reports are available 48 hours after draw. Final reports are available in 5 days, if no growth.

- Positive specimens are reported to nursing unit by telephone, giving all provisional data, immediately upon recognition. This should be reported to physician as soon as possible. 

 

Collection Instructions

For children or difficult sticks, use 1 BACTEC^TM Peds Plus^TM/F bottle.
Infants 2 months of age and under DO NOT use FREPP 1.5 ml ChloraPrep. (may cause irritation or chemical burns). Use 70% isopropyl alcohol (2 separate wipes) to prepare venipuncture site.

For adults use 1 BACTEC^TM Plus Aerobic/F bottle and 1 BACTEC^TM Standard Anaerobic/F bottle.

Site Selection:

-Select a different site for each culture drawn.
-Avoid drawing blood through indwelling intravenous or intra-arterial catheter unless blood cannot be obtained by venipuncture or unless diagnosis of catheter sepsis is suspected.

Site Preparation

   Site preparation: FREPP 1.5 ml ChloraPrep (2% chlorhexidine gluconate (CHG) and 70% isopropyl alcohol 

BACTEC^TM blood culture collection using butterfly set (direct draw):

A. Open butterfly package.

B. Utilizing tourniquet, identify site for venipuncture.

C. Using 5-mL graduations on label of vial, mark fill line at approximately 10 mL above present liquid level.

D. Remove caps from blood culture bottles and wipe with alcohol.

E. Remove needle sheath and perform venipuncture by holding butterfly wings.

F. Place bottle into holder, puncturing stopper by pushing  bottle forward into holder. Holder must be held onto bottle. Keep bottle in an upright position; watch blood until it fills to your pen line. Remove bottle and insert  next bottle. Draw additional tubes if needed.

G. When final tube is filled, withdraw needle by grasping wings and gently pulling. Activate safety butterfly devices. Cover site with sterile gauze pad or cotton ball.

Note:  In certain situations, it may be difficult to obtain desired amount of blood. These are acceptable minimum draws:

1. Peds Plus - 1 mL to 3 mL (3 mL optimal)

2. Aerobic Plus - 3 mL to 10 mL (8-10 mL optimal)

3. Anaerobic/F - 3 mL to 7 mL (5-7 mL optimal)

4. Mix bottles well to avoid clotting.

5. After phlebotomy, cleanse site with 70% alcohol to remove remaining iodine, which can cause irritation in some patients.

6. Label bottles with patient’s computer label. Be careful not to cover bottle’s barcode.

7. Maintain sterility and forward promptly.