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Test Code BLDCULLINE Blood Culture Line Draw

Additional Codes

ALAB: BLDCULLINE
Powerchart: Culture Blood Line Draw
MA Cerner: NA

Specimen Requirement

Preferred Collection Method:

Adult Routine: 16-20 mL of blood drawn from blood line catheter to inoculate both aerobic and anaerobic blood culture bottles.

Collection Instructions:

  1. Prepare the BD Bactec Plus Aerobic/F bottle and  BD Bactec Plus Anaerobic/F Bottle by removing the plastic caps and wiping the tops of the bottles with 70% isopropyl alcohol. DO NOT USE IODINE. Use a fresh prep pad for each bottle.
  2. Obtain 16-20 ml of blood specimen from blood line catheter using a syringe.
  3. Immediately, first inoculate the BD Bactec Plus Anaerobic/F Bottle using a transfer device with female luer so no air will be introduced into the anaerobic bottle. Second, inoculate the BD Bactec Plus Aerobic/F bottle using the same device.

  4. Allow each bottle to fill by vacuum. Never force the syringe plunger down during inoculation. Sample splashing may occur. Remove the syringe when the fill amount is reached, as the vacuum automatically will draw more than the recommended maximum. Puncture the bottle stopper vertically to avoid releasing the vacuum; a bottle without a vacuum should not be inoculated.

  5. Mix the bottle contents by inverting the bottles 4-5 times.

  6. Label the tubes with patient’s name, a second identifier (patient ID, DOB, etc.), date/time of collection and initials of the person collecting the specimen.

  7. Transport to the lab as quickly as possible.

Alternate Collection Method:

Adult Routine: 8.3 mL of blood collected from a blood line catheter and dispensed into each of two yellow-top vacuum tubes containing SPS which acts as an anticoagulant.

Collection procedure:        

  1. Prepare each of the two yellow-top SPS vacuum tubes by wiping the tops of the bottles with 70% isopropyl alcohol. DO NOT USE IODINE. Use a fresh prep pad for each tube.
  2. Obtain a blood specimen from the blood line catheter using a syringe.
  3. Attach a needle to the syringe and insert the needle into the first tube and allow the vacuum in the tube to draw the blood into the tube. Never force the syringe plunger down during inoculation. Sample splashing may occur. Remove the syringe when the fill amount is reached. Puncture the tube stopper vertically to avoid releasing the vacuum; a tube without a vacuum should not be inoculated.
  4. Mix the both tube contents by inverting the tubes 4-5 times.
  5. Label the tubes with patient’s name, a second identifier (patient ID, DOB, etc.), date/time of collection and initials of the person collecting the specimen.
  6. Transport to the lab as quickly as possible. The lab will transfer the sample from the  SPS vacuum tubes into the Bactec culture bottles when received.

Additional Specimen Collection Information

The optimal time for the collection of blood cultures is as soon as possible after the onset of fever or chills or whenever serious infection is suspected. Most cases of bacteremia are detected by using two to three sets of separately collected blood cultures drawn in the initial 24 hour period of onset. More than three sets of blood cultures yield little additional information. Conversely, a single blood culture may miss intermittently occurring bacteremia and make it difficult to interpret the clinical significance of certain isolated organisms. The ideal time interval between blood collections is 30-60 minutes; however in medically urgent situations in which antibiotic therapy is to be started immediately in the critically ill patient, two separate blood culture specimens are collected within a few minutes and then antibiotic therapy is started. When two or more specimens are collected within a few minutes, these collections are made separately and collected from different arms.

  • Volume of Blood: The volume of blood is critical because the concentration of organisms in most cases of bacteremia is low, especially if the patient is on antimicrobial therapy. the concentration of organisms in infants and children during bacteremia is higher than in adults, so less blood is required for culture.
  • Fungus: If a fungus only blood culture is ordered, collect 2 BD Bactec Plus Aerobic/F bottles or 2 SPS yellow-top vacuum tubes. If a Fungus Culture, Blood is ordered in addition to a routine Blood Culture, no extra tubes are required and the specimens are collected and handled as outlined above for adult - routine. A notation must be made on the requisition designating that the culture is a Fungus Culture, Blood.
  • Mycobacteria: If a request for a mycobacteria culture (Acid-Fast Culture) is received, collect 1 SPS yellow-top vacuum tube and transport to Microbiology immediately.

Test Method

Screen for Positive: Bactec FX; BD

Confirmation: Vitek 2

Performance

Blood Culture: 

  • Final Negative: After 5 day.
  • Preliminary Positive: When growth is detected.

Fungus: 4 weeks

Mycobacterium: 6 weeks

Reference Values

No growth

  • Critical Value: Growth

All positive Blood Cultures are called to the physician office or nursing station as soon as growth is detected. Any bacterial growth is identified and MICs are performed when appropriate.

CPT Code Information

87040 Identification of Microorganisms; Culture, bacterial; blood aerobic, with isolation and presumptive identification of isloates (includes anaerobic culture, if appropriate)

Useful For

Detection of microorganism in blood specimens.

LOINC Code Information

600-7 Bacteria Identified In Blood By Culture