Specimen Requirements

Do not order this test between 0600 and 0759 unless order is STAT.

Since media into which blood specimen is placed has been developed as enrichment broth to encourage multiplication of even 1 bacterium, it follows that these media will enhance growth of any stray contaminating bacterium such as normal inhabitants of human skin.

It is undesirable to draw blood through a vascular shunt or catheter, since these prosthetic devices may harbor colonizing bacteria that are not present in circulating blood of patient; and blood obtained through foreign material would yield false-positive results. It is also recommended to draw blood below an existing intravenous line, if possible, since blood above line will be diluted with fluid being infused.

Preparation of Patient and Collection of Blood

1. It is preferable, whenever possible, that blood for blood culture be drawn prior to initiation of antibiotic therapy.

2. Choose a vein to be drawn by touching skin before it has been disinfected.

3. Clean site with Alcohol Prep. 

4. Open Chlorhexidine swab and DO NOT unfold.  Hold swab between thumb and index finger.

5. Apply swab to skin using repeated back-and-forth strokes for 15 sec.

6. Allow the prepped area to air dry for 30 seconds.

7. Do not blot or wipe dry.

8.  Place each blood culture bottle on a flat surface and make a mark 10 mLs above the culture medium using the graduated indicators of the bottle label. 

9.  Using standard procedures, perform venipuncture using a 12” butterfly and needle adapter. 

10.  Place the aerobic bottle on a flat surface or hold it straight up and down.

11.  Insert adapter/needle apparatus over the bottle and puncture the septum.

12.  Holding the adapter down, allow the blood to flow into the aerobic bottle until the draw level reaches the (10mL) mark which you previously made.

13.  Release the adapter.  Invert the bottle immediately after collection to prevent clotting.

14.  Collect the Anaerobic bottle by repeating steps 8 though 11.

15.  Collect other blood work as required.  Always collect Blood Cultures first.

16.  Label the blood cultures immediately taking care not to cover the barcode on the bactec vial.  Record the time of the draw, initials, and site of collection on the remaining aliquot label.  Perform the necessary recheck for proper patient identification as with any blood collection.

17. Maintain sterility and forward promptly at ambient temperature only.

Volume Requirements

Specimen must arrive within 4 hours of draw.

Pediatrics (<5 Years)

1 to 3 mL (minimum volume: 0.5 mL) of blood in a BACTEC Peds Plus culture bottle. Do not overfill bottle. (Improperly labeled specimen, <0.5 mL of blood, specimen exposed to cold, or specimen not received within 4 hours of draw is not acceptable.)

Note: 1. Patient’s age, sex, clinical diagnosis, date and time of draw, current antibiotic therapy, and specimen source are required.

2. Three specimens drawn at half-hour intervals is recommended.

3. No more than 4 blood cultures should be ordered within a 24 hour period unless a microbiologist is consulted.

Pediatrics (>5 Years) or Adults

10 mL (minimum volume: 5 mL) of blood in a BACTEC Aerobic culture bottle and 10 mL (minimum volume: 5 mL) of blood in a BACTEC Anaerobic culture bottle. Do not overfill bottles. (Improperly labeled specimen, <1 mL of blood, specimen exposed to cold, or specimen not received within 4 hours of draw is not acceptable.)

Note: 1. Patient’s age, sex, clinical diagnosis, date and time of draw, current antibiotic therapy, and specimen source are required on request form for processing.

2. Three specimens drawn at half-hour intervals is recommended.

3. No more than 4 blood cultures should be ordered within a 24 hour period unless a microbiologist is consulted.