II. Indications: Evaluation of Bacterial Infection
- Bacteremia
- Sepsis
III. Technique
- Preparation of skin
- Chlorhexidine (preferred agent for antiseptic)
- Superior to Povidone-Iodine
- Superior to Alcohol
- Povidone-Iodine
- Wait to draw blood for 2-3 minutes after applying
- High contamination rate compared with Chlorhexidine
- References
- Chlorhexidine (preferred agent for antiseptic)
- Standard collection protocol
- Collect up to 3-4 sets of Blood Culture bottles
- Two Blood Culture bottles in each set
- Obtain 5 ml blood per bottle
- Draw from up to 3 different venipuncture sites
- Space blood collections by 1 hour intervals
- Collect up to 3-4 sets of Blood Culture bottles
- New collection protocol: Six bottle method
- Collect 6 bottles from one venipuncture (total 40 ml)
- Based on mathematical model
- Predicts highest sensitivity and Specificity
- References
IV. Efficacy
- Sensitivity
- Increases with number of Blood Cultures drawn
- With 3 Blood Cultures, Sensitivity approaches 90%
- Study of hospitalized patients with persistent fever
- Post-Antibiotic culture unlikely to yield pathogen
- Obtain pre-antibiotic Blood Culture and await results
- Grace (2001) Clin Infect Dis 32:1651-5 [PubMed]