Specimen Requirements

VERY IMPORTANT:

Draw blood cultures before starting antimicrobial therapy. 

1. It is recommended to draw at least 2 blood culture sets per septic episode as the chances of recovering a pathogenic organism increase with additional cultures.
2. No more than 3 sets will be allowed on any patient during a 24-hour period. 
3. Please consult the microbiologist if more than 3 sets are ordered in a 24-hour period.

Specimen Type: Blood

Container/Tube: BacT/ALERT blood culture bottle sets (BacT/ALERT SN and BacT/ALERT FA)
Specimen Volume: See Collection Instructions

Collection Instructions: Draw blood as follows:

Note: Pediatric blood culture bottles are not acceptable for ages 11 and older.

1. Disinfect stoppers of blood culture bottles with 70% alcohol and allow to dry.
2. Use ChloraPrep kit as follows to disinfect skin:

• Peel off package cover to remove ChloraPrep.
• Hold applicator without touching sponge. Pinch wings once to break ampule. You should hear a pop.
• Saturate sponge with ChloraPrep by gently pressing it against venipuncture area. Using a back and forth motion, completely wet treatment area for 30 seconds.
• Allow to dry completely (30 to 60 seconds). Do not blot or wipe solution away. Discard applicator after a single use.

If ChloraPrep kits are not available, disinfect skin as follows:

1. Thoroughly cleanse venipuncture site with 70% alcohol moving in concentric circles to periphery. Allow to dry. If site must be touched during venipuncture, disinfect gloved fingers.
2. Repeat previous step using iodine. Allow to dry 30 to 60 seconds or wipe with a sterile gauze.
3. Adult blood culture set consists of 2 bottles, 1 aerobic and 1 anaerobic. Draw 10 mL (minimum volume: 4 mL) of blood per bottle for adults. Always fill Green bottle first, then orange bottle.
4. Gently invert bottles 4 to 5 times to mix.
5. Label bottles with patient’s legal name, date and actual time of collection, and type of specimen.

Note:

1. Blood cultures should not be drawn through a line unless they cannot be obtained by venipuncture. If drawn from a line, discard first 5 mL drawn, unless a “line” is to be cultured.
2. Method of specimen collection and amount of blood drawn directly influence success of recovery of isolates and interpretation of results.
3. Factors directly influencing culture results:

• Volume of blood drawn is perhaps the most important factor.

• Method of skin disinfection is also critical.

Specimen Type: Bone marrow

Container/Tube: Yellow-top (SPS)

Specimen Volume: 0.5 mL

Specimen Minimum Volume: 0.1 mL

Collection Instructions:

Collect specimen as follows; sterile technique must be maintained in all steps of collection.

1. Disinfect stopper of tube with 70% alcohol and allow to dry. Repeat with iodine.
2. Thoroughly cleanse overlaying skin with 70% alcohol, followed by 2% iodine tincture, moving in concentric circles to periphery. Do not remove iodine.
3. Specimen must be collected by physician trained in this procedure.
4. Obtain bone marrow.
5. Place sterile, 18-gauge needle on syringe and inject bone marrow into tube by puncturing stopper with needle.
6. Gently invert tube 4 to 5 times to mix.
7. Label tube with patient’s legal name, date and actual time of collection, and type of specimen.

Note: 

1. Protect specimen from temperature extremes.
2. When shipping, try to keep specimen as close to ambient temperature as possible.