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Blood Culture ([LAB000185])
Test Mnemonic:

 C BLDN - Blood Culture Screen

Specimen Requirements:

8-10 mL fill is optimal for Aerobic and Anaerobic bottles. 1-3 mL fill is optimal for a Pedi bottle.

For Pediatric collection recommendations, see below:

Test Included:

Aerobic and anaerobic bacteria and yeast, organism identification and antimicrobial susceptibility, if appropriate.

Collection:

https://www.medialab.com/dv/dl.aspx?d=1412131&dh=21147&u=87474&uh=bc5aa

 

Do not touch phlebotomy site after cleansing to prevent false positive culture growth. Use a syringe or butterfly to collect 16-20 mL of blood. Pediatric patients, collect 1-3 mL of blood, depending on the weight of the patient. Inject blood into the alcohol-cleaned aerobic and anaerobic blood culture bottles.

Container:

Bactec Bottles -  Aerobic/F Plus, and Lytic/10 Anaerobic/F, or Peds Plus /F

Minimum Volume:

16-20 mL of whole blood evenly divided into two blood culture bottles (aerobic and anaerobic). If the patient is a difficult draw or a small volume of blood is available, inoculate one Pedi bottle with 1-3 mL. 

Storage/Transport:

Room temperature. Do not refrigerate. Do not put blood culture bottles in pneumatic tube system. Transport to laboratory immediately.

Specimen Preparation:

Inject blood into the alcohol-cleaned aerobic and anaerobic blood culture vials. Inject 8-10 mL into the aerobic bottle; inject 8-10 mL into the anaerobic bottle. If a pedi bottle is used, inject it with 1-3 mL of blood.

Stability:

As soon as possible; 24 hours

Causes for Rejection:

Refrigerated bottles, submission of vials other than BACTEC bottles, specimen container unlabeled or labeled incorrectly, no date and time of collection on specimen or missing collector information on order. No site of draw indicated. Expired bottles. Bottles with cracks or bulging tops.

Reference Range:

No organisms isolated.

Turnaround Time:

5 - 8 days

Methodology:

BACTEC FX - continuous monitoring instrument, then if necessary, Gram stain and culture including identification and susceptibility.

Performed:

Clinical Microbiology

Synonyms:

Blood Culture Screen, blood; Bacterial Blood Culture; Septicemia; Bacteremia

Clinical Indication:

Suspected bloodstream infection with aerobic bacteria, anaerobic bacteria, or yeast.

Patient Preparation :

After locating a vein, cleanse the venipuncture site thoroughly with 70% isopropyl alcohol.
Using a ChloraPrep One-Step, start at the middle of the site and swab concentrically. 
Allow the site to dry and do not re-palpate.

Mark the BACTEC vial to the desired fill level.

An 8 - 10 mL fill is optimal per Aerobic or Anaerobic bottle.
Remove flip-off caps, wipe bottle tops with alcohol pad and allow to dry.

After performing venipuncture, select Aerobic bottle first, hold upright and collect to level marked on vial. Once filled, remove bottle and immediately fill the second, Anaerobic bottle, to level marked.
If using a Pedi bottle (pink label/silver top) the required fill is 1-3 mL.

CPT 4 Code:

87040, additional charges, if indicated

 

Note:

Collect specimens using aseptic technique since contamination may lead to false positive results. Collect two sets of cultures per febrile episode. Positive culture results are considered a critical value and notification will be performed upon recognition of the positive result.

DO NOT COVER THE BOTTLE BAR CODE 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.

When ordering tests for which Medicare or Medicaid reimbursement will be sought, physicians should only order tests that are medically necessary for the diagnosis or treatment of the patient. Components of the organ or disease panels may be ordered individually. The diagnostic information must substantiate all tests ordered and must be in the form of an ICD-10 code or its verbal equivalent.
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