1 History 2 Purposes 3 Risks 4 Method 5 See also 6 References
Set 1 = left antecubital fossa at 0 minutes Set 2 = right antecubital fossa at 30 minutes Set 3 = left or right antecubital fossa at 90 minutes
Ordering multiple sets of cultures increases the probability of discovering a pathogenic organism in the blood and reduces the probability of having a positive culture due to skin contaminants. After inoculating the culture vials, advisably with new needles and not the ones used for venipuncture, the vials are sent to the clinical pathology microbiology department. Here the bottles are entered into a blood culture machine, which incubates the specimens at body temperature. The blood culture instrument reports positive blood cultures (cultures with bacteria present, thus indicating the patient is "bacteremic"). Most cultures are monitored for five days, after which negative vials are removed. If a vial is positive, a microbiologist will perform a Gram stain on the blood for a rapid, general identification of the bacteria, which the microbiologist will report to the attending physician of the bacteremic patient. The blood is also subcultured or "subbed" onto agar plates to isolate the pathogenic organism for culture and susceptibility testing, which takes up to three days. This culture and sensitivity (C&S) process identifies the species of bacteria. Antibiotic sensitivities are then assessed on the bacterial isolate to inform clinicians with respect to appropriate antibiotics for treatment.  Some guidelines for infective endocarditis recommend taking up to six sets of blood for culture (around 60 ml). See also
^ Madeo M, Davies D, Owen L, Wadsworth P, Johnson G, Martin C (2003). "Reduction in the contamination rate of blood cultures collected by medical staff in the accident and emergency department". Clinical effectiveness in Nursing. 7: 30–32. doi:10.1016/s1361-9004(03)00041-4. ^ Kiyoyama T, Tokuda Y, Shiiki S, et al. (2009). "Isopropyl alcohol compared with isopropyl alcohol plus povidone-iodine as skin preparation for prevention of blood culture contamination". J Clin Microbiol. 47 (1): 54–58. doi:10.1128/JCM.01425-08. PMC 2620854 . PMID 18971366. ^ Bouza E, Sousa D, Rodríguez-Créixems M, et al. (2007). "Is blood volume cultured still important for the diagnosis of bloodstream infections?". J Clin Microbiol. 45 (9): 2765–9. doi:10.1128/JCM.00140-07. PMC 2045273 . PMID 17567782.
Department of Health (2007) Saving lives: Reducing infection,
delivering clean and safe care London: DoH
Donnino MW, Goyal N, Terlecki TM, et al. (September 2007). "Inadequate
blood volume collected for culture: a survey of health care
professionals". Mayo Clin. Proc. 82 (9): 1069–72.
doi:10.4065/82.9.1069. PMID 17803874.
Madeo M, Barlow G (July 2008). "Reducing blood-culture contamination
rates by the use of a 2% chlorhexidine solution applicator in acute
admission units". J. Hosp. Infect. 69 (3): 307–9.
doi:10.1016/j.jhin.2008.03.009. PMID 18511153.
Madeo M, Jackson T, Williams C (November 2005). "Simple measures to
reduce the rate of contamination of blood cultures in Accident and
Emergency". Emerg Med J. 22 (11): 810–1.
doi:10.1136/emj.2005.003079. PMC 1726605 .
Mimoz O, Karim A, Mercat A, et al. (December 1999). "Chlorhexidine
compared with povidone-iodine as skin preparation before blood
culture. A randomized, controlled trial". Ann. Intern. Med. 131 (11):
Shore A, Sandoe J (2008). "