Blood Culture - Pediatric Show Microbiology Specimen Instructions: A single set of blood cultures to detect BSIs is inadequate. See
Smart Sets to request multiple sets.
A blood culture "set" consists of an aerobic and anaerobic bottle. To
detect bacteremia with reasonable certainty, for each set, draw the
following MINIMUM* volumes of blood and split this volume between two
bottles as follows:
Prenatal/NICU < 1500g
Draw Volume: 0.5 mL
Bottles to Inoculate: Aerobic (blue top, 924171)
Prenatal/NICU >1500g
Draw Volume: 0.5-1.0 mL
Bottles to Inoculate: Aerobic (blue top, 924171)
Up to 1 year
Draw Volume: 1.0 mL
Bottles to Inoculate: 50% Aerobic (blue top, 924171)
50% Anaerobic (purple top, 924172)
1+ years
Draw Volume: 1 mL per year of age
Bottles to Inoculate: 50% Aerobic (blue top, 924171)
50% Anaerobic (purple top, 924172)
*To maximize volume, use the phlebotomy protocols listed below under
Reference Links.
**Do not exceed maximum of 2.5% of the estimated blood volume of the
patient or 10 mL per bottle. Filling bottles (10 mL each) may be
appropriate for adult-size children regardless of age.
If molds, Blastomyces, Histoplasma, Nocardia, or Malassezia spp. are
suspected, order: Microbiology: Fungus Blood Culture (LAB2217) as
these organisms are not detected well by typical blood culture. For
detection of Candida bloodstream infection a fungal culture is
unnecessary and inefficient, instead, draw the volume above and
inoculate into two aerobic bottles.
Recommendations
For suspected bloodstream infection (BSI), collect 3 sets (6 bottles)
prior to antibiotic therapy (except for NICU infants; see table above)
from separate sites. Ideally, three venipunctures should be performed
immediately but a third set of bottles can be drawn at a 4-6 hour
delay without significant loss of yield.
Skin Preparation
1) Clean the site with an alcohol pad, moving in a concentric circle.
Allow the alcohol to dry.
2) Pediatric: Cleanse skin with ChloraPrep 1.5 mL Frepp Applicator
(907672)
NICU: Follow the NICU standard of practice for skin prep.
Open ChloraPrep applicator and squeeze the wings together to release
the antiseptic. Do not touch the sponge. Wet the sponge by
repeatedly pressing and releasing the sponge against the skin until
the liquid is visible. Scrub the site vigorously, with a side to side
motion, for at least 30 seconds. Allow the site to air dry for at
least 30 seconds or until it is completely dry.
2.1 (Alternate method) If the patient is allergic to chlorhexidine,
prep site with a 30 second 70% alcohol scrub. Let the site dry
and then apply tincture of iodine in a concentric circle,
starting at the center and let dry.
2.2 (Alternate method) If the patient is allergic to chlorhexidine
and iodine, scrub the site vigorously with 70% alcohol for
60 seconds and let dry.
3) Consult guidelines above for blood craw and bottle fill volumes. As
necessary, remove overcaps from bottles and cleanse each rubber
septum with separate 70% alcohol swabs. Allow septum to dry 1 min.
before inoculating.
4) Draw and inoculate bottles according to the chart above. Transport
time <2 h.
5) Label bottles with either Cerner or Epic labels; do not cover the
bar code label. Record the time, collection site, and your
initials.Testing Schedule: 24 hrs/day, 7 days a week, including holidays. Turn Around Time: Cultures are monitored continuously for 5 days. Comments: References Department of Pathology Policies and Procedures: Methodology: Automated, continuous monitoring. Recommended textbook solutions
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Introduction to Epidemiology7th EditionRay M. Merrill 237 solutions What antiseptic do you use for a blood culture?Among the evaluated antiseptics, isopropyl alcohol may be the optimal antiseptic for use prior to obtaining blood for culture, given its convenience, low cost, and tolerability. Blood cultures are important for the diagnosis and management of bloodstream infections.
What do you clean the skin with before blood culture?Thoroughly disinfect venipuncture site by vigorously cleansing for 30 seconds back and forth across the site with a new 70% isopropyl wipe followed by 2% chlorhexidine antiseptic (ChloraPrep One Step®). 4. Allow ChloraPrep® to dry completely (at least 30 seconds). Do NOT wipe the site with gauze.
What must you do to blood culture bottles before using them?Which blood culture bottle do I use first? The aerobic bottle should be inoculated first as there is about 0.5 cc of air in the line of the collection set and sometimes it is difficult to obtain 8-10 cc of blood per bottle (16-20 cc/set). The aerobic bottle is the more critical one to inoculate short samples into.
What must be used to disinfect the tops of blood culture bottles?6. Remove the top from the blood culture bottles. Disinfecting the top of the bottle with alcohol or iodine prep. Do not use the chloraprep meant for the patient phlebotomy prep.
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Which antiseptic is commonly used for skin preparation prior to drawing blood culture bottles?
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