C BLDN - Blood Culture Screen

Collection of 8-10 mL of blood is optimal for Aerobic and Anaerobic bottles. 1-3 mL of blood is optimal for a Peds bottle.

Culture for aerobic and  anaerobic bacteria and yeast; organism identification and antimicrobial susceptibility, if appropriate.

After locating a vein, cleanse the venipuncture site thoroughly with 70% isopropyl alcohol.  Use a ChloraPrep One-Step to concentrically swab outwardly beginning at the collection site.  Allow the site to dry and DO NOT RE-PALPATE.  Mark the BACTEC bottles to the desired fill level by locating the hatch marks on the side of each bottle.  Mark the initial volume of the fluid contained in the bottle and then count two (2) hatch marks above the initial vollume and mark again.  Each hatch mark indicates 5 mL.  Remove flip-off cap(s) from bottle(s), wipe with alcohol pad and allow to dry.  Use a butterfly or syringe to collect 8-10 mL of blood into each bottle, beginning with the aerobic bottle (gray label/blue ring top) first, followed by 8-10 mL into the anaerobic bottle (purple label/purple ring top).  For pediatric or difficult-to-draw patients, collect 1-3 mL into a Peds Plus bottle (pink label/silver top).  Wipe tops of bottles with alcohol prep after collection is complete.  Collect two sets of cultures per febrile episode from separate collection sites, or wait a minimum of 15 minutes if using the same collection site.

DO NOT COVER BARCODE ON BOTTLE WITH PATIENT LABEL.  Place patient label perpendicular to the bottom of the bottle.

BACTEC Bottles

• Aerobic bottle - Plus Aerobic/F (gray label, blue ring top, gray cap)
• Anaerobic bottle - Lytic/10 Anaerobic/F  (purple label, purple ring top, purple cap)
• Pedi bottle - Peds Plus/F (pink label, silver ring top, pink cap)

Check bottles for expiration date before using.  Do NOT cover barcode on bottle with patient label.  Prior to use, inspect each bottle for evidence of contamination, damage, or deterioration.  Store BACTEC bottles in a cool, dry place - out of direct sunlight.

For Aerobic and Anaerobic bottles, a minimum of 3 mL in each bottle should be collected.  For a Peds bottle, a minimum of 0.5 mL should be collected.

Room temperature. Do not refrigerate. Do not put blood culture bottles in pneumatic tube system.

After cleaning bottle top(s) with alcohol swab, inject 8-10 mL of blood into each Aerobic and Anaerobic blood culture bottles.  Inject 3 mL into Peds bottle.

Transport to laboratory as soon as possible.

• In-house patient specimens: submit to laboratory within 2 hours
• Clinic patient specimens:  submit to laboratory within 24 hours

Refrigerated bottles, submission of vials other than BACTEC bottles, unlabeled or improperly labeled bottles, no date and time of collection on specimen or missing collector information on order.  Blood cultures are included on the Specimen Exception List. 

No growth

Negative cultures are held 5 days.

BACTEC FX - continuous monitoring instrument.  Positive bottles are sub-cultured and organisms identified using laboratory protocol.  Susceptibilties are performed, if appropriate.

Clinical Microbiology

Culture, blood; Bacterial blood culture; Brucella blood culture; septicemia; bacteremia

Suspected bloodstream infection with aerobic, anaerobic bacteria, or yeast

Follow directions using blood culture cleansing kit for cleansing of the venipuncture site.  Inadequate cleansing may result in contamination or false positive cultures.

87040, additional if indicated

Positive culture results are considered a critical value and notification will be performed upon recognition of positive result.

DO NOT COVER BAR CODE LABEL ON BOTTLE WITH PATIENT LABEL.  Place patient label perpendicular to bottom of bottle.

Optimal blood volume for culture is 8-10 mL (1-3 mL for Peds bottle).  A suboptimal volume of blood can adversely affect recovery and/or time of detection of organisms.  Interpret results accordingly.