Culture, blood

Culture, blood

my clinician had send my lab blood culture and urine culture from a pt. who hhad h/o fever three days and uti symptoms. urine showed pyuria and grew candida spp where as blood culture grew e.coli sensitive to ceftriaxone. now clinician is asking he was suspecting uti so why did urine culture despite pyuria did not grow e.coli? second what is the relivance of e.coli in blood when pt. is not showing any signs of sepsis other than fever. at the same time he admits that pt. was put on hrs.ceftriaxone to which pt. responded in 48 hrs. pl answer this.
(answered 06/06/2007)

Can you tell me where I can find a comparison of the Trek, Bactec , and Bac T ALERT blood culture systems ?I am specifically interested in Trek's claim that their bottles do not require solids to absorb antibiotics ( as the FAN and PLUS bottles are designed to do.
(answered 05/29/2007)

Do you know if there is any reason why LMX/Lidocaine creme could not be used on a pediatric patient if blood cultures are being drawn. Would cleaning the site immediately prior to drawing the blood culture negate the effect of the lidocaine?
(answered 05/29/2007)

I have a question regarding decontamination of indwelling catheters prior to collection of blood cultures from that line. It seems to me it should be decontaminated the same way you would a peripheral draw. Any info would be helpful along with any references I might find. Thanks!
(answered 04/07/2007)

We have had several months where our ER physicians seem to be ordering alot of blood cultures. Our infection control department is inquiring about what is practical. One particular practice common to most of the doctors is to order blood cultures x2 before any blood work has been processed. Is this typical? Acceptable? I know at one point in addition to fever of unknown origin was the CBC results. Is this still practiced? What if any, are the criteria to determine if a blood culture is warranted?
(answered 03/28/2007)

LMX/lidocaine creme and blood cultures. Is there a problem with using lidocaine creme and then cleansing the site for a blood culture draw? Would the numbing effect of the creme be changed by cleansing with ChloraPrep immediately before the blood culture draw?
(answered 03/20/2007)

If you must draw BC X 2 from the one and ONLY ONE sight a patient has-what is the minimum time you must wait between the collection of those two cultures?
(answered 03/01/2007)

I am ask to make a plan for the movement of the BacT/Alert System to a new location within the building. It's for a project for the senior technologist at canadian blood services. I'm ask to answer this following things: required documentation, required activities, communication plan, timeline and list of required support needed to enable this move. I will really appreacite any information you can give me and please get back to me as son as you can. Thanks in advance.
(answered 02/27/2007)

Re:Positive blood cultures I would like to know what the time frame would be for a positive blood culture reoccurence to be considered the same episode or a different one. In other words, if a patient has E.coli on day 1 and then again when redrawn 4 days later (same strain), what is the cutoff time frame for a new "episode". Thank you elizabeth.jambard@nashobamed.com
(answered 02/26/2007)

can we use chloraprep on blood culture bts top instead of alcohol during collection.
(answered 02/01/2007)

When our lab reports a pos blood culture they include the number of positive bottles in the set. ie:gpc's in one bottle only of set. Our physicians ask for this info to help determine a true septicemia vs a contaminant. A new ID physician recently told us this is outdated.Are there established criteria to determine a true septicemia vs contamination? Are the number of positive bottles in a set part of the criteria for determining contamination? Thank you
(answered 11/09/2006)

are there any national organizations that have set forth specific guidelines or recommendations on collecting > 1 set of blood cultures?
(answered 11/08/2006)

We have a physician who thinks that it is a waste of time and money to submit both aerobic and anaerobic bottles on blood cultures. She would like to change the procedure to submit only the aerobic bottle except in certain situations. Is this an acceptable practice?
(answered 10/09/2006)

What is acceptable correlation for moving from manual blood culture to automated?
(answered 08/23/2006)

Several Oncology Nurses from our Institution attended an Oncology Meeting in Boston in late May 2006. When they came back, they all said that one of the speakers, Jill Dickerson, RN from Tyler Cancer Center in Tyler, TX, discussed blood culture collection from IV lines in detail during her presentation. They were told that there was no need to flush approximately 5 ml of blood from the lines before collecting the blood into Bactec bottles. All my references (up to 2004) suggest that lines be flushed before collecting the specimen." "What is ASM's view on this type of blood culture collection from IV lines? Please give me references too. I will meet with the group on Friday, 30 June. Thanks!"
(answered 06/27/2006)

The infection diseases' specialist at our institution wants to to have CVP tip cultures reported as 'extra-luminal' growth (for which Maki, with a 15 cfu cutoff should be used), and 'intraluminal' growth (a modification of Brun-Buisson and Cleri, where 1 ml broth in flushed through the catheter, 0.1ml cultured, and >1000cfu/ml is regarded as significant.) The infection control team uses both these values to determine whether it was only colonization (only extra-luminal growth), or catheter-related sepsis (intra-luminal also positive). At the moment we do only Maki's technique. I have been reading up on it, and it seems as if the quantitative methods, such as the Brun-Buisson method, is more sensitive, but I find no articles specifically talking about intra-and extra-luminal cultures as separate entities. I am also in the predicament that I cannot just substitute Maki for a quantitative method, since our clinicians are used to getting BOTH from other institutions. Please help.
(answered 06/26/2006)

Iv therapy has asked me for the most current guidelines and recommendations for drawning blood cultures from central lines. How to clean, is discarding blood necessary prior to collecting the culture, how far apart and is there a reference to the fact that if a central line is in should a peripheral and a line culture always be done? thanks
(answered 06/26/2006)

Are there any criteria for determining the signigicance of isolating diphtheroids from 2 blood cultures?On 2 occasions it grew from a port draw.There was no arm stick done.On another occasion,diphtheroids grew from the port draw and an arm stick.Is this enough to say that diphtheroids was significant ?
(answered 06/02/2006)

Our patient demographics is such that on ocassion, single-bottle blood culture set is drwan. Is it better to inocculate a Pediatric bottle or an aerobic bottle? Is better to draw 2 aerobic bottle if no anaerobic bottle is avaiable?
(answered 03/31/2006)

If only enough blood can be obtained from an adult to inoculate one blood culture bottle, should the aerobic or anaerobic bottle be chosen? If only an aerobic bottle were done, we would fail to isolate strict anaerobes. If only an anaerobic bottle were done, we are concerned that we would not be able to isolate Pseudomonas.
(answered 03/31/2006)

If only 1 bottle for blood culture can be drawn, is it better to use a Pediatric bottle or an aerobic bottle from an adult patient and why?
(answered 03/31/2006)

Several years ago, the decision was made to discontinue use of pediatric bottles on our BacT/Alert because generalist technologists had difficulty reading gram stains from these bottles. Is it an acceptable practice not to use pediatric blood culture bottles in children?
(answered 03/30/2006)

How long should you incubate a blood culture for Brucella using the BacT/Alert 3D, and is one aerobic bottle sufficient? What can I use for a reference in my procedure?
(answered 01/26/2006)

Timing for blood culture.The recommendation is to take 2 sets of blood culture before antibiotic therapy.what is the recommended time to draw the second set ? knowing the practice in our institution, i recommended that one set is to be drawn before the antibiotic is given and another set is drawn 30-60 minutes before the next dose of antibiotic is given.is this acceptable?
(answered 11/23/2005)

In our lab,we are using BacT/Alert system for blood culturing. I just want to know if the system detecting the positive bottle,do we need to take out certain amount of broth and spin down to do the Gram stain or just take out a few drop of broth and make a thin smear. Because according to first edition of Handbook of Clinical Microbiology stated the details procedure but not on 2nd edition.
(answered 11/07/2005)

The ID doctors feel that the appropriate management for bacteremia/septicemia is to continue to draw daily blood cultures after the first positive until the bacteria are cleared from the blood while on appropriate antimicrobials. Is this standard practice.
(answered 09/30/2005)

A common practice in our ER is to stick a patient with a butterfly, draw one set of blood cultures, continue to draw all other blood work, and then draw a second set of blood cultures. This is then considered to be two sets of blood cultures. Can you comment on this practice?
(answered 09/01/2005)

Concerning preparation of the site prior to collecting a blood culture, our policy is to use 70% alcohol followed by 2% iodine tincture or 10% povidone iodine. Phlebs draw the blood cultures on morning rounds while the nursing staff do the draws the remainder of the day. Infection control is considering allowing the nursing units to use chloraprep to decontaminate the site instead of alcohol and iodine since that is what they use for other procedures and they like it. Is one way really any better than the other? I would appreciate any feedback.
(answered 08/31/2005)

We currently use 10% Povidone-Iodine solution equivalent to 1% available iodine to disinfect for blood cultures. I was recently asked why we are not using chlorohexidine as it is a superior disinfectant. Are there any guidelines or references as to what is the best disinfectant for blood cultures? Thank you, A. Tarrant
(answered 08/26/2005)

What is considered an "acceptable" contamination rate for blood cultures and where can I find a reference?
(answered 06/17/2005)

Does methicillin resistant coag negative Staph isolated from blood cultures ever show different morphotypes? If different morphotypes are present, do you assume they are different strains of coag negative Staph, and must you speciate them and do sensitivities on each? The assumption is that they are present in more than one bottle.
(answered 06/16/2005)

We have been asked recently to draw blood cultures during transfusion of blood products. The unit is not discontinued and blood culture drawn per transfusion rx protocol. The physician has requested that the blood cultures be drawn while the patient is being transfused. This has happened several times on the Oncology Ward. It seems best to wait until the procedure is completed but I have no documentation to support this. What are your thoughts and references that address this practice?
(answered 06/15/2005)

What quide line should one use when calculating blood culture contamination rates. We are looking for a mathematical formula to document in our procedure manual.
(answered 05/11/2005)

Are there controlled studies that document that there is no loss of organism detection by reducing the length of incubation in automated instruments from seven to five days?
(answered 04/21/2005)

We have recently been asked whether it is appropriate or not to draw blood cultures while a patient is being transfused. Do you know of any references that address this issue? Thank you.
(answered 04/14/2005)

Are there any guidelines that state how long blood culture bottles should be held?
(answered 03/03/2005)

What is the current recommendation of length of time to hold blood cultures before reporting them as negative? We hold ours 5 days but I have seen literature stating 3 days is sufficient.
(answered 02/15/2005)

What about the necessity to always collect aerobic and anaerobic bottles for each set of blood cultures
(answered 01/25/2005)

In the case of a positive blood culture (one set) where both bottles have gram negative rods in the gram stain is it necessary to perform identification and sensitivities on both bottles or is it acceptable to do a full workup on only one bottle and wait for subcultures to confirm that both bottles yield the same organism based on colony morphology?
(answered 11/29/2004)

this concerns a question that was answered 11/05/03" What is considered the national average rate of false blood cultures?" In your comment, you make the statement "depending on the cohort (institutions are cohorted based on size and type of services provided). " How do we determine our "cohort". We are a 100 bed full service rural hospital.
(answered 11/16/2004)

Our laboratory is tracking the number of solitary blood cultures each month, as a quality indicator. I am having difficulty in finding a solid definition of "solitary," as determined by time between draws of sets. In other words, is it best to set the maximum amount of time between two sets at 1 hour, 2 hours, 6 hours, etc, before calling in a "solitary." Also, any ideas on an approximate threshold for percentage of adult solitary cultures that would be acceptable, realizing that there are certain medical situations that may require a longer time between draws, such as in endocarditis? Thank you.
(answered 11/15/2004)

How much work up is required to identify coagulase negative staphylococci isolated from multiple blood culture sets? Is it sufficient to perform a complete work up on the first positive set and minimal work up the other positive sets or does each set require a full work up?
(answered 11/10/2004)

Paired blood cultures to detect catheter-related bacteremia were addressed on 4/2003, but I'm wondering if more specific information is available now. We have just begun collecting paired blood cultures from venous and line. There is a discrepency in the literatature as to how much volume to draw (5 ml in one aerobic bottle vs 10 ml each in aerobic/anaerobic bottles per site) and whether or not to clear the line. Clearing the line will get rid of heparin, antibiotics, etc., but might also be getting rid of the organisms that need to be cultured. Any help you can give would be appreciated.
(answered 10/23/2004)

Do you have any guidelines to "gross out" blood cultures with multiple organisms. We have recently had a couple of blood cultures in which a couple of strains of S. epidermidis and a couple of strains of fastidious gram negative rods were isolated. Should these organisms be worked up, or should the cultures be reported as having gross contamination?
(answered 10/05/2004)

Can the incubation time of blood cultures from suspected endocarditis patients be reduced from 21 days to 5 days, as per routine blood cultures, with continuous monitoring blood culture systems?
(answered 09/30/2004)

Although not recommended,we still have yellow top tubes collected for our blood cultures.We immediately inoculate bottles when tubes are brought to the lab.Is there a requirement for the size needle to be used--we currently buy 20g needles and use proguard II needle holders.Would it be wrong to use our 21 g safety needles needles (the same ones used for patients)?
(answered 09/27/2004)

Are there guidelines for the workup of positive line blood cultures with possible skin contamination (ie ,coag neg staph ,alpha strep not entc or pnc).I am mainly interested in line blood c/s that are positive with such organisms and should they be worked up.
(answered 09/21/2004)

What are the QA parameters for blood cultures?
(answered 08/09/2004)

Most laboratories freeze the organism itself when isolated from a positive blood culture; is there any recommendation for saving the blood culture bottle itself; what would be the recommended storage for the bottle, room temperature or incubator, and how long (with the understanding each labs space will dictate this piece)?
(answered 06/21/2004)

what is the current recommended ratio of blood to liquid media. the septi check system says 8-10 ml for a 70ml volume while the bact/alert says about the same for a 40ml bottle.
(answered 06/04/2004)

Can you collect blood culture on patient during haemodialysis?
(answered 03/22/2004)

blood culture contamination- my Infection control people are calssifying bactereamia as 'true' according to CDC/NNIS recommendations which they say are: the patient has clinical signs of infection, the patient has One positive culture set and is on Vancomycin or the patient has two sets of positive cultures and not on antibiotic therapy. Should the samples be classed as 'true' bactereamia if only one set of cultures are taken and the patient has been put onto Vancomycin? Also, what is the effect on the cultures taken if the patient has been started on the anti biotic before the culture is drawn?
(answered 04/09/2004)

Have you ever heard of blood cultures being drawn at the same time from different sites? An MT demonstrated to a phlebotomist how she draws two sets of blood cultures, at the same time, using butterflies, in two veins. None of us have ever heard of this and don't expect to find it in any references because the concept seems so bizzare. Any coments from the experts?
(answered 04/02/2004)

Definition of Contaminant in Blood cultures? References Please!!
(answered 03/23/2004)

We are trying to define contaminants using the CAP guidelines to calculate contamination rate. In a series of blood culture specimens that is positive with an established pathogen, such as E coli, should a single set that has a coag neg Staph along with the E coli be counted as a contaminated blood culture?
(answered 03/23/2004)

Can you collect blood culture on patient during haemodialysis?
(answered 03/22/2004)

is there any evidence behind taking blood cultures during fever?
(answered 03/19/2004)

I have a question about blood culture validation. What, if any, are the recommendations for validating a new blood culture machine? The manufacturer has given us a procedure for seeding bottles with known organisms. Do we also have to include actual patient samples? Or is just the seeded bottles (20 different organisms) adequate?
(answered 11/14/2003)

Can you provide any references/guidelines for the evaluation and laboratory work-up of positive blood cultures with organisms suggestive of skin flora contamination (ie.- diphtheroids, coagulase negative staph, strep viridans from one blood set only).
(answered 11/11/2003)

What is considered the national average rate of false positive blood cultures?
(answered 11/06/2003)

Is there any problem if I process an hemolized blood-culture?,Cuold it be processed as a regular blood culture?
(answered 10/29/2003)

Well, in blood culture collection procedure; is there a recommended order in which the bottles are drawn? Do we draw blood for the anaerobic bottle first or the aerobic bottle first ? And another question; would it matter if air was introduced into the aerobic bottle??
(answered 10/17/2003)

Situation : a gram + coccus in clusters is found in our Bactec system. It seems reasonable that a drop or 2 of the blood culure broth added to 0.5 cc coag plasma could give us a tentative or probable answer of S. aureus or coag + Staph IN 3 OR 4 HOURS instead of waiting for colonies. Any references or comments regarding this modification of the tube coag test is appreciated. If the answer is in the affirmative, please give a reference so I can get this in the SOP.
(answered 08/01/2003)

GUIDELINES FOR PHYSICIAN WHEN TO ORDER BLOOD CULTURES. CURRENTLY FROM ED WE ARE RECEIVING MANY BLOODCULTURE BOTTLES (PROBABLY MOST PATIENT COMING THROUGH ED) WE WANT TO FIND OUT WHEN OHYSICIAN SHOULD ORDER BLOOD CULTURE X2,
(answered 07/28/2003)

Bac/T alert vs Bactec 9240 - comparison for blood culture, advantages of one compared to the other
(answered 05/28/2003)

What are the current recommendations for reporting sensitivities on coag negative staph isolated in a single bottle or single set of blood cultures
(answered 05/13/2003)

When drawing blood cultures, what is the recommended time to wait before drawing a second set? Is it immediately after the first set is drawn, 15 minutes, 30 minutes, 1 hour?
(answered 04/28/2003)

I realize that current references discourage the collection of blood cultures from lines unless there is no other option. However, we have cases where physicians are wanting the blood culture collected from a line as well as from a peripheral venous source. In such cases, how should the blood be collected? Should 5 ml or so be discarded before collecting the specimen or should the initial 5 ml collected be placed into bottles. Secondly, are there any interpretative guidelines for blood culture collected from lines?
(answered 04/25/2003)

What is the maximum length of time that a blood culture, from a secondary lab, can sit, before being placed in the Bactec incubator?
(answered 04/14/2003)

I am compiling data about how many of our patients have only had one set of blood cultures drawn. Is there a recognized age below which only one set is acceptable? 1 year old?
(answered 03/07/2003)

Our hemodialysis unit draws blood cultures thru the indwelling "shunt" line. Are there guidelines for collecting blood cultures from 'dialysis patients'?
(answered 03/05/2003)

back to Archive Index