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Standard Operating Procedures For Collection, Delivery And Reporting Of Blood Culture Specimens
Oct 09, 2018

Standard operating procedures for collection, delivery and reporting of blood culture specimens

First, blood culture indications


Patients with chills, body temperature over 38 ° C or hypothermia, suspected blood flow infection, especially in the following cases, blood should be used for bacterial and fungal culture: hospital pneumonia; indwelling central venous catheter more than 72h; infective endocarditis Osteomyelitis; severe underlying disease, immunodeficiency with symptoms of systemic infection; clinicians suspect other conditions of possible bloodstream infections.


Second, the timing of blood collection


Once blood flow infection is suspected, blood should be taken immediately for culture. It is best to collect it in the cold and fever after 24 hours of antibacterial treatment.


Third, the blood collection process


(1) Disinfection


1. Culture bottle disinfection procedure: disinfect the culture bottle rubber stopper with disinfectant solution, and use it after drying.


2, skin disinfection procedures: disinfection solution from the puncture point to the outside circle to disinfect, to the disinfection area diameter of more than 5cm, after the disinfection solution is evaporated and dried (usually more than 30s) puncture blood collection.


(two) venipuncture and culture bottle inoculation


After the adult uses a syringe to take blood aseptically, drain the air inside the needle and directly inject it into the blood culture bottle. Do not change the needle (if the second puncture or blood is taken with the scalp needle, the needle should be replaced), first inject anaerobic Cultivate the bottle, avoid injecting air, then inject it into the aerobic culture flask and mix gently to prevent blood from clotting. In recent years, negative pressure blood culture bottles have been widely used in clinical practice, and blood is directly inhaled from the patient's vein into the blood culture bottle to reduce the pollution.


(three) matters needing attention


1. The test sheet should indicate the patient's information such as the use of antibacterial drugs, the time and location of blood collection, and clinical diagnosis.


2, the blood collection site is usually the elbow vein, suspected bacterial endocarditis when the blood collection of the elbow artery or femoral artery is appropriate, should not be taken in the intravenous drip of antibacterial drugs. Unless a catheter-related bloodstream infection is suspected, blood should not be taken from the indwelling vein or arterial catheter because the catheter is easily contaminated by normal skin flora.


3, the number of blood collection: For adult patients, blood samples should be collected at two sites at the same time, the same strain can be isolated in two different parts to determine the pathogen.


4, bacterial endocarditis: take blood 3 times within 24h, each interval is not less than 30min; if necessary, do blood culture 2 times the next day.


5, blood collection: the ratio of medium to blood 10:1 is appropriate, to dilute antibacterial drugs, antibodies and other bactericidal substances in the blood. Too little blood collection will significantly reduce the positive rate. Adults take 8~10ml of blood per culture bottle every time, and infants take 2ml of blood per culture bottle.


Fourth, shipping requirements


1. All specimens should be sent to the laboratory immediately after collection, preferably within 2 hours. If it cannot be sent in time, it should be placed at room temperature. The blood culture bottle should be sent to the laboratory before being placed in the incubator and should not be temporarily stored in the refrigerator.


2, the inspection specimen should be correctly pasted barcode, indicating the sampling time and inspection time.


3, safety protection: the container of the specimen must be leak-proof, it is forbidden to send the leaked specimen to the laboratory.


V. Reporting requirements


(1) Emergency oral (telephone) report


Gram staining and microscopic examination are performed immediately when a positive alarm occurs in blood culture, and the results are reported to the clinical doctor in an emergency (oral) report in the shortest time. The oral report contains the following internal preview:

Rong, and recorded.


(1) The full name (or job number) of the reporter;


(2) the time of the report;


(3) The full name (or job number) of the doctor contacted;


(4) Report the results of the microscopic examination and emphasize its urgent value;


(5) Confirm that the clinician receives the report and repeats the results.


(2) Final result (written) report


(1) Sterile growth (no growth of oxygen-free bacteria and anaerobic bacteria for 5 days);


(2) Positive culture results (final identification results, final drug susceptibility results).


(3) Other reports and records


1. When the specimen is rejected, it is necessary to immediately notify the clinic to immediately re-collect blood and record it.


2. The final result is inconsistent with the results of the emergency oral report. When the change is needed, the clinical need to be notified immediately, and the correct result must be provided in the written report, indicating the content of the change.


3. Records of other matters requiring clinical attention, such as insufficient blood collection, long specimen placement time, and insufficient specimen collection.