Culture - Blood

Culture - Blood

Blood cultures are incubated for five days, which is adequate for recovery of fastidious organisms including HACEK organisms. Requests for extended incubation times will be denied. First time positive bottles (within a seven-day period) will have molecular blood culture identification performed by multiplex PCR. This multiplex PCR assay detects the following organisms and antibiotic resistance genes: Enterococcus faecalis, A.baumannii, C.albicans, E. faecium, B. fragilis, C. glabrata, L. monocytogenes, S. maltophilia, C. krusei, Staphylococcus sp., Enterobacterales, C. parapsilosis, S. aureus, E. cloacae complex, C. tropicalis, S. epidermidis, E. coli, C. auris, S. lugdunensis, K. oxytoca, Cryptococcus neoformans/gattii, Streptococcus sp., K. pneumoniae group, P. aeruginosa, S. agalactiae, Klebsiella aerogenes, Salmonella sp., S. pneumoniae, Proteus sp., S. pyogenes, S. marcescens, H. influenzae, N. meningitidis (encapsulated). Antimicrobial Resistance Genes: Extended-Spectrum Beta-Lactamases (ESBL) (CTX-M), Carbapenemases (OXA-48-like, NDM, VIM, IMP, and KPC), Methicillin Resistance (mecA/C, mecA/C and MREJ (MRSA)), and Vancomycin Resistance (vanA/B).

Blood

BACTEC Blood Culture Media

BD Bactec Bottles are maintained at Room Temperature 1. Draw 20 mL (minimum volume: 3 mL) of blood in BD BACTEC Plus Aerobic medium- culture bottle and a BD BACTEC Plus Anaerobic medium- culture bottle. 8 - 10 mL of blood per bottle is optimum for organism recovery. For pediatric patients or difficult to draw patients, draw 1- 3 mL's of blood in a BD BACTEC Peds Plus medium- culture bottle. 2. Choose vein to be drawn by touching skin before it has been disinfected. 3. Cleanse skin over venipuncture site in a circle approximately 5 cm in diameter with Chlorhexidine (CHG), rubbing vigorously. 4. Starting in center of circle, apply 2% iodine (or povidone-iodine) in ever-widening circles until entire circle has been saturated with iodine. Allow iodine to dry on skin for at least 1 minute. The timing is critical; a watch or timer should be used. 5. If site must be touched by phlebotomist after preparation, phlebotomist must disinfect fingers used for palpation in identical fashion or must palpate through a sterile glove. (“Universal Precautions” dictates that phlebotomists wear gloves.) 6. Insert needle into vein and withdraw blood. Change needle and cleanse tops of bottle(s) with 70% alcohol before injecting blood into culture bottles. Do not overfill or underfill the bottles. 7. After needle has been removed, site should be cleansed with 70% alcohol again as many patients are sensitive to iodine. 8. Label bottles with patient’s name (first and last), date and actual time of draw, and type of specimen. 9. Maintain sterility and forward promptly at room temperature. Note: It is recommended that 2 sets of cultures be drawn initially from separate sites. 10. Samples must be delivered to the laboratory within 48 hours of draw. 11 Specimen source and draw site are required on request form for processing. The volume of blood cultured is critical because the number of organisms per mL of blood in most cases of bacteremia is low, especially if the patient is on antimicrobial therapy. In infants and children, the number of organisms per mL of blood during bacteremia is higher than adults, so less blood is required for culture.

Transport at Room Temperature

• Maintain sterility and forward promptly at room temperature. Samples must be in laboratory within 48 hours of draw. • Refrigerated: Unacceptable • Frozen: Unacceptable

Culture using automated continuous monitoring system.

Monday through Sunday

Northwell Health Laboratories-Little Neck Parkway

87040

6201045