Combating Infection: Blood cultures: 5 steps to doing it right
Frank Edward Myers III, MA, CIC
Ceasar Reyes BA, CLS, ASCP

March 2011 
Volume 41  Number 3
Pages 62 - 63
  PDF Version Available!

DRAWING A BLOOD CULTURE specimen correctly is important because poor technique could lead to additional discomfort for the patient, additional testing, longer hospital stays, and associated expenses.1 In addition, if the specimen is contaminated, the resulting culture may be falsely positive, usually for organisms commonly found on the skin. The patient may then receive unnecessary antibiotics to treat organisms that aren't causing disease. Unnecessary antibiotics put the patient at greater risk for acquiring a multidrug-resistant organism and acquiring Clostridium difficile.Rates of blood culture contamination vary widely, with a range 0.6% to 9.1%, in part because standards for defining contamination vary.2,3 Most facilities consider a blood specimen contaminated if the isolates classified as contaminants were coagulase-negative Staphylococci, viridans group and nonhemolytic Streptococci, Corynebacteria, Micrococci, and nonpathogenic Bacillus and Neisseria species.4Rates of blood specimen contamination vary with the experience of the clinician, including how often the clinician draws blood specimens. How much time the clinician has to accomplish the task is another factor: The less time available, the higher the contamination rate.3The steps for drawing a blood culture specimen outlined in this article are general guidelines; become familiar with your facility's practices and follow them.Unless otherwise specified by a healthcare provider, blood culture specimens can be collected over a short time frame according to your facility's policy (5 minutes apart, 10 minutes apart). If possible, avoid drawing a culture specimen from a patient taking an antibiotic-draw the specimen before the patient starts it. If drawing the specimen afterward is unavoidable, some automated blood culture lab testing systems provide special vials that neutralize the effects of the antibiotic.Collect no more than two to three sets of blood specimens over a 24-hour period (more sets may be drawn

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