Memorandum



493395664210____________________________________________________ ____________Memorandum mercy recommended guidelines for the collection of blood cultures_________________________________________________ _______ ___________ Blood Culture Collection Guidelines for AdultsClinical SettingNumber of sets(from separate sites)Timing between setsAcute sepsis25 - 15 minutesFever of Unknown Origin2 > 1 hour* Subacute Endocarditis34 – 8 hours **Obtaining cultures during a fever spike is most likely to yield an identifiable pathogen.Use peripheral veins.Catheters and peripheral lines can be contaminated with bacteria on their surfaces that aren’t found in the blood stream.Choose appropriate disinfectant.Chlorhexidine, unless unavailable or contraindicated.Let disinfectant sit on skin for full amount of time recommended by manufacturer.Obtain 20 – 30 mL volume per set.Volume is the most important variable in recovering a pathogen in blood culture. Never order a single set of cultures. Single blood culture yield information that is difficult to interpret and likelihood of recovering a pathogen is lower than if multiple sets had been obtained. Do not delay starting antibiotics due to difficulty collecting a culture.Repeat cultures only if indicated.Positive blood cultures do not require follow up cultures to document the infection has cleared in most circumstances. In patients with infective endocarditis or Staph aureus bacteremia, repeat cultures at 72 hours after initiation of antibiotic treatment are appropriate.References:Baddour LM, et al. Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications. Circulation. 2015;132:1435-1486.Clinical and Laboratory Standards Institute, Subcommittee on Principles and Procedures for Blood Cultures. Principles and Procedures for Blood Cultures; Approved Guideline. CLSI document M47-A. Clinical and Laboratory Standards Institute; PA 2007.Liu C, et al. Clinical Practice Guidelines by the Infections Diseases Society of America for the Treatment of Methicillin-Resistant Staphylococcus aureus Infections in Adults and Children. Clinical Infections Diseases. 2011 Feb 1;52(3):e18-e55.Miller, et al. Specimen Management in Clinical Microbiology. 3rd ed. Washington DC: ASM Press; 2017.Wilson ML, et al. Laboratory Detection of Bacteremia and Fungemia in: Jorgensen JH et al. Manual of Clinical Microbiology, 11th ed. Washington DC: ASM Press; 2015. p. 15 – 28. ................
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