Collection Instructions

The time of collection must be indicated. Strict aseptic technique is essential. Remove the plastic cap from the blood culture bottles, swab the stoppers with 70% isopropyl alcohol and allow to dry, collect 16-20 mL of blood for adults and use a weight based approach for pediatrics/neonates. Inoculate the blood obtained evenly into both bottles. If less than 1ml obtained, innoculate all into the green FA Plus aerobic bottle. Timing: the clinical status of the patient should be the primary guide to the timing of blood cultures. Studies demonstrate no difference in yield whether cultures are obtained simultaneously (from separate sites) or at spaced intervals. Blood cultures should be drawn prior to initiation of antimicrobial therapy when at all possible. For suspected sepsis, meningitis, osteomyelitis, arthritis, or acute untreated bacterial pneumonia: obtain two or three large volume sets of blood cultures, one each from different sites, such as the left and right arms, collected immediately before starting treatment. For fevers of uncertain origin (e.g. occult abscess, typhoid fever, brucellosis or other undiagnosed febrile syndrome) obtain two or three blood cultures, one right after the other, from different sites initially. If these are negative after 24-48 h of incubation, obtain two more blood cultures, one right after the other, from different sites. For acute infective endocarditis: obtain three blood cultures from three separate venipuncture sites and begin therapy. For subacute infective endocarditis, obtain three blood cultures with the first 24 hours. Space collection collection over 24 hours. In cases of suspected bacterial bacteremia or fungemia with persistently negative blood cultures consider alternative blood culture methods designed to enhance recovery of mycobacteria, fungi, and rare or fastidious microorganisms.