blood culture
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Indications
Clinical significance
- two sets of blood cultures collected at different sites should be obtained with each episode of fever
- all blood cultures should be positive if bacterial endocarditis is the source of bacteremia
- for other sources of bacteremia, there may be more intermittent shedding of organisms into the blood
- prior antimicrobial therapy may reduce the yield
- sodium polyanetholesulfonate (SPS, 0.025-0.05%) included in culture bottles as anticoagulant may interfere with recovery of Neisseria gonnorhoeae & Neisseria meningitidis
- gram staining of blood cultures read as negative in an automated system revealed slow-growing pathogens in 0.13% of cultures[6]
Specimen
- adults
- infants
- collect 1-5 mL of blood per 100 mL culture bottle
- collect both aerobic & anaerobic cultures
- sodium polyanetholesulfonate (SPS, 0.025-0.05%) should be included in culture bottles
- use of sterile gloves reduces contamination rate[4]
- sterile technique & a checklist reduces contamination rate by nearly 50%[5]
* specify if fastidious organisms are suspected (Brucella, leptospirosis)
Management
- all positive blood cultures should be followed with echocardiography to assess presence of endocarditis[3]
- transthoracic echocardiogram (TTE) on all patients
- transesophageal echocardiogram (TEE) if TTE is negative
More general terms
More specific terms
- bacteria identified in blood by culture
- bacteria identified in cord blood by culture
- blood culture for fungus/Mycobacterium
Additional terms
References
- ↑ Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed., W.B. Saunders, 1995
- ↑ Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 491
- ↑ 3.0 3.1 Medical Knowledge Self Assessment Program (MKSAP) 14, American College of Physicians, Philadelphia 2006
- ↑ 4.0 4.1 Kim N-H et al. Effect of routine sterile gloving on contamination rates in blood culture: A cluster randomized trial. Ann Intern Med 2011 Feb 1; 154:145 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21282693
Kim JY and Rosenberg ES. The sum of the parts is greater than the whole: Reducing blood culture contamination. Ann Intern Med 2011 Feb 1; 154:202. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21282700 - ↑ 5.0 5.1 Journal Watch. Jan 30, 2014 Massachusetts Medical Society http://www.jwatch.org
Self WH et al. Reducing blood culture contamination in the emergency department: An interrupted time series quality improvement study. Acad Emerg Med 2013 Jan; 20:89 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23570482
Hall RT, Domenico HJ, Self WH, Hain PD. Reducing the blood culture contamination rate in a pediatric emergency department and subsequent cost savings. Pediatrics. 2013 Jan;131(1):e292-7 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23209105 - ↑ 6.0 6.1 Peretz A et al. Performance of Gram staining on blood cultures flagged negative by an automated blood culture system. Eur J Clin Microbiol Infect Dis 2015 Apr 16; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25877009 <Internet> http://link.springer.com/article/10.1007%2Fs10096-015-2383-0