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Test Code LAB462 Blood Culture

Useful For

The diagnosis of septicemia

Methodology

Bactec FX Culture System

Performing Laboratory

Bozeman Health Laboratory Services

Specimen Requirements

Specimen Type: Blood

Container/Tube: Bactec FX collection bottles (vials)


Collection Instructions:

Prepare Blood Culture Bottles:

  1.  Aseptically remove plastic cap from blood culture bottles.
  2. Swab rubber stopper on each bottle with 70% isopropyl alcohol. Wait 1 minute to allow drying.

Prepare Patient:

  1. Apply tourniquet to patient’s arm.
  2. Palpate area to locate vein.
  3. Remove tourniquet.
  4. Prepare arm using a Chlora-Prep Blood Culture Prep Kit as follows:
    1. Remove prep from kit. Hold applicator with sponge facing downward. Gently squeeze wings, releasing solution for a controlled flow. Press sponge against selected site to saturate.
    2. Scrub vigorously back and forth (friction scrub) for 30 seconds (2 minutes for wet sites). Allow to dry for 30 seconds.

Draw Blood:

  1. Reapply tourniquet. Do not touch site.
  2. Use a syringe and needle to draw blood. Do not draw directly from arm using a Vacutainer adapter. A butterfly device with adapter may be used, but bottles must remain upright.
  3. Draw 10 mL of blood for each culture bottle (5 mL for pediatric bottle).
  4. Release tourniquet, and apply pressure to venipuncture site with a sterile gauze while removing needle from vein.
  5. Introduce blood into Bactec FX bottles according to chart below.
  6. Label bottles with patient’s name, identification number, date and time of collection, and type of specimen.
  7. Send specimens to laboratory within 2 hours of draw.  If delayed, hold blood culture bottles at room temperature until transport.
Age Bottle Set Blood Draw Volume Bactec Bottle Volume
Children

1 pediatric bottle

(pink bottle)

 1 - 5 mL Place entire volume in pediatric bottle
Adults

2-bottle set

aerobic and anaerobic

(purple and blue bottle)

 16-20 mL Split equally between aerobic and anaerobic bottles
13 -16 mL Place 8 mL in aerobic bottle and 5 to 8 mL in the anaerobic bottle
10 - 12 mL  Place 5 to 7 mL in the aerobic bottle and 5 mL in the anaerobic bottle
5 - 9 mL  Place entire volume in aerobic bottle

Additional Information

Diagnosis # of sets to be drawn # of separate draw sites Timing of Blood Draws
Acute sepsis 2-3 unspecified Draw all sets within 10 minutes
Acute endocarditis 3 3  Draw sets over 1-2 hours
Subacute endocarditis 3  3  Draw sets ≥15 minutes apart.  If negative at 24 hours, obtain 3 more sets.
Fever of Unknown Origin 2-3 2-3  Draw sets ≥1 hour apart.  If negative at 24 hours, obtain 2-3 more sets.
  • Do not draw more than 3 sets of blood cultures within a 24-hour period.
  • Indicate on request form if fastidious organisms such as Brucella, Francisella, nutritionally-variant Streptococci, Leptospira, Fochalimea hemselae, cell wall-deficient forms (eg, Streptobacillus moniliformis), or Bartonella are suspected so that blood cultures can be held for the appropriate time, or referred to Mayo Medical Laboratories for testing.
  •  Hold bottles at ambient temperature before inoculating with blood.
  • If the culture is positive, then a Gram stain, identification, and susceptibilities will be performed at an additional charge.

Specimen Transport Temperature

Ambient

Specimen Stability

Specimen Type Temperature Time
Bactec FX Bottles Ambient 48 hours

 

Reference Values

No growth after 5 days

 

Critical value (automatic call-back): positive

Day(s) Test Set Up

Monday through Sunday

Test Classification and CPT Coding

87040-Culture

87150-Blood Culture ID (if appropriate)

87076-Anaerobic identification (if appropriate)

87077-Aerobic identification (if appropriate)

87186-Susceptibilities (if appropriate)

87205-Gram stain (if appropriate)