Blood Culture & Sensitivity Quantitative (Line)

General Information

Lab Name
Blood C/S (Line), Quantitative
Lab Code
BLDQLC
Epic Name
Blood Culture, Quantitative, Line
Description

Quantitative blood cultures are used to determine whether an IV line is the source of bacteremia.

This test should be ordered as paired quantitative line blood Blood Culture & Sensitivity Quantitative (Line) [BLDQLC] and peripheral blood Blood Culture & Sensitivity Quantitative [BLDQNC]. For positive culture, see FEE: Filmarray Blood Culture Identification [ADBCBF].

Per IDSA Guidelines, "For quantitative blood cultures, a colony count of microbes grown from blood obtained through the catheter hub that is at least 3-fold greater than the colony count from blood obtained from a peripheral vein best defines catheter-related bloodstream infection." [Mermel, CID 2009:49]

BacT/Alert blood culture bottle collection, labeling and transport information

Synonyms
Pour Plate Blood Culture
Components

Interpretation

Method

BacT/ALERT bottles are incubated in the BioMerieux Virtuo which continuously monitors the bottles for growth of microorganisms. Once growth is detected, a rapid identification system is used to identify organisms and resistance genes. See FEE: Filmarray Blood Culture Identification [ADBCBF]. Organisms are isolated on solid agar media using conventional culture techniques. Final identification of any bacteria isolated is by MALDI-TOF Mass Spectrometry or molecular sequencing. Susceptibility testing is performed on most isolates. Staphylococcus species that are coagulase negative (except S. lugdenensis), Bacillus species and presumptive diphtheroids do not get automatic susceptibility testing. Please inform lab if susceptibility testing is needed for those isolates.

One milliliter of blood from the SPS tube is mixed with agar and poured into a petrie dish. The plate is examined for growth for 3 days to determine the colony count. If there is no growth on the plate the colony count is entered as <1 colony/ ml. If there is growth on the plate, the number of colonies is counted and entered and colonies / ml.

Reference Range
See individual components

Ordering & Collection

Specimen Type
Blood from line draw
Collection

Collect blood culture bottles before collecting yellow top SPS tube. Do NOT overfill or underfill. Do not place patient label over the barcode label.

Note: Whenever possible, inoculate the maximum volume for optimal sensitivity of culture. Refer to "Nursing Services Policy and Procedures for Nursing Care: Obtaining Blood Culture" procedure.

Disinfect draw site AND BOTTLE TOPS. Allow to dry. Collect 8-10 mL blood in 1 FA Plus aerobic blood culture bottle and 8-10 mL in 1 FN Plus anaerobic blood culture bottle.

Yellow top SPS tube: Disinfect draw site and yellow top SPS TUBE TOP. Collect 8-10mL blood in a 10 mL yellow top SPS tube (Verify anticoagulant is SPS and NOT an ACD tube). Note: Underfilled tubes (<5 mL) will be rejected.

Unacceptable: any other anticoagulant.

BacT/Alert blood culture bottle collection, labeling and transport information

Handling Instructions

Transport at room temperature to the laboratory ideally within 30 minutes after collection, or within 12 hours if transporting from an outside location. Specimens received in blood culture bottles or yellow top SPS tubes >12 hours after collection will be rejected. Viability of organisms is significantly reduced after 12 hours.

Transport in the pneumatic tube system: Place plastic blood culture bottles and yellow top SPS tube in a large biohazard specimen bag with the request slip. Then place the bagged bottles between TWO sections of foam padding inserts before sending the specimens in the pneumatic tube system.

Quantity
Requested: Approximately 8mL in a 10mL yellow top SPS tube and 8-10 mL in each aerobic/anaerobic bottle. Use fill lines on the side of the bottle to gauge the correct blood volume.
Minimum: 5mL in a 10mL yellow top SPS tube and 0.5 mL in one aerobic blood culture bottle (may also include 0.5 mL in one anaerobic blood culture bottle).

Processing

Receiving Instructions

At SDES prompt, enter BLUD, phlebotomy site, and bottle description, e.g. BLUD-PICC-AABT. Bottles should be placed in blood culture instrument ASAP. See Setup manual for instructions on setting up pour plate.

HMC midnight shift refrigerates the SPS tube and leaves a message to alert dayshift Microbiology.

Misc Sendout

Performance

Lab Department
Microbiology(MC)
Frequency
HMC: daily 6:00 to 23:30 UW-MT: Processed upon receipt
Available STAT?
No
Performing Location(s)
HMC Microbiology
206-744-5858

325 9th Ave, Rm # GWH-47, Seattle, WA 98104-2420

UW-MT Microbiology
206-520-4600

Clinical Lab, Room # NW177,
University of Washington Medical Center,
1959 NE Pacific street, Seattle, WA 98195

Billing & Coding

CPT Codes
87040
LOINC
600-7