Blood culture

BLOOD CULTURES

Specimen type

Blood culture taken by aseptic technique

Optimal time of specimen collection

Before antimicrobial therapy where possible.
As soon as possible after a spike of fever, except in endocarditis where timing is less important

Correct specimen type and method of collection

Use SA(aerobic) and SN(anaerobic) bottles for routine blood cultures. If the patient is on antibiotics or fungaemia is suspected, use the FAN bottle (FA) + SN bottle. Use the Paediatric (PF) bottle in all situations for children.

For the culture of Mycobacterium species from blood, contact the Bacteriology Department on ext: 4772.

The collection of blood cultures must be by an aseptic technique.

Wash your hands

Prepare your trolley and equipment. Before use, inspect the blood culture bottle for defect and check expiry date. The sensor (at the bottom of the bottle) should be intact and dark green ; the broth should be clear. Remove the plastic flip top from the blood culture bottle and sterilise the exposed rubber septum with ethanol or isopropyl alcohol.

Wash hands again before venepuncture and wear gloves.

Disinfect the skin at the selected venepuncture site carefully and thoroughly using Chloraprep Frepp (70% alcohol and 2% chlorhexidine).

Use of a butterfly needle with a protective plastic cup attached may make the procedure easier. Blood culture bottles should be inoculated first to avoid contamination.

Complete request form. If the sample is taken through an intravenous catheter or other access device, indicate this on the request form.

http://uhsm-intranet:20003/training/VideoFiles/blood.swf

Quantity and number of specimens

Adults

20 ml for each blood culture set i.e. 10 ml in each bottle.

Children and neonates

Preferably, a volume of 1-2ml in neonates, 2-3 ml in infants and 3-4ml in pre-teen children for each blood culture set.

Do not exceed the manufacturer's recommended maximum volume for each bottle as shown on label.

General

Take two sets before antibiotics for each septic episode (a single set is adequate for neonates) but do NOT delay antibiotic treatment.

If endocarditis is suspected, take 3 sets of blood cultures over the course of 60 minutes, if possible; or over 24 hours if patient clinically stable.

N.B. Use a separate venepuncture for each set of blood cultures.

Laboratory analysis

Identification and sensitivity testing for all isolates.

Labelling and transport of specimens

Label each bottle with patient's full name, D.O.B. and ward. If attaching a label do not cover the barcode; overlay the label already attached. Do not remove the barcode label, this is for laboratory use only

Send blood cultures immediately to the Laboratory where they will be incubated. DO NOT REFRIGERATE.

Transport in a sealed plastic bag.

Blood Culture Bottles

ROUTINE

labelled "SA" and "SN"

PATIENT ON ANTIBIOTICS OR FUNGAEMIA SUSPECTED

labelled "FA" and "SN"

PAEDIATRIC

labelled "PF"

Use SA and SN for routine blood cultures. If the patient is on antibiotics or fungaemia is suspected, use the FAN bottle (FA) + SN bottle. Use the Paediatric (PF) bottle in all situations for children.

	Specimen type	Blood culture taken by aseptic technique
	Optimal time of specimen collection	Before antimicrobial therapy where possible. As soon as possible after a spike of fever, except in endocarditis where timing is less important
	Correct specimen type and method of collection	Use SA(aerobic) and SN(anaerobic) bottles for routine blood cultures. If the patient is on antibiotics or fungaemia is suspected, use the FAN bottle (FA) + SN bottle. Use the Paediatric (PF) bottle in all situations for children. For the culture of Mycobacterium species from blood, contact the Bacteriology Department on ext: 4772. The collection of blood cultures must be by an aseptic technique. Wash your hands Prepare your trolley and equipment. Before use, inspect the blood culture bottle for defect and check expiry date. The sensor (at the bottom of the bottle) should be intact and dark green ; the broth should be clear. Remove the plastic flip top from the blood culture bottle and sterilise the exposed rubber septum with ethanol or isopropyl alcohol. Wash hands again before venepuncture and wear gloves. Disinfect the skin at the selected venepuncture site carefully and thoroughly using Chloraprep Frepp (70% alcohol and 2% chlorhexidine). Use of a butterfly needle with a protective plastic cup attached may make the procedure easier. Blood culture bottles should be inoculated first to avoid contamination. Complete request form. If the sample is taken through an intravenous catheter or other access device, indicate this on the request form. http://uhsm-intranet:20003/training/VideoFiles/blood.swf
	Quantity and number of specimens	Adults 20 ml for each blood culture set i.e. 10 ml in each bottle. Children and neonates Preferably, a volume of 1-2ml in neonates, 2-3 ml in infants and 3-4ml in pre-teen children for each blood culture set. Do not exceed the manufacturer's recommended maximum volume for each bottle as shown on label. General Take two sets before antibiotics for each septic episode (a single set is adequate for neonates) but do NOT delay antibiotic treatment. If endocarditis is suspected, take 3 sets of blood cultures over the course of 60 minutes, if possible; or over 24 hours if patient clinically stable. N.B. Use a separate venepuncture for each set of blood cultures.
	Laboratory analysis	Identification and sensitivity testing for all isolates.
	Labelling and transport of specimens	Label each bottle with patient's full name, D.O.B. and ward. If attaching a label do not cover the barcode; overlay the label already attached. Do not remove the barcode label, this is for laboratory use only Send blood cultures immediately to the Laboratory where they will be incubated. DO NOT REFRIGERATE. Transport in a sealed plastic bag.

	ROUTINE		labelled "SA" and "SN"
	PATIENT ON ANTIBIOTICS OR FUNGAEMIA SUSPECTED		labelled "FA" and "SN"
	PAEDIATRIC		labelled "PF"