Alberta Precision Laboratories

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Organization:

Alberta Precision Laboratories

Test Name/Synonym:

Blood Culture, Routine
(Synonym: Bacteremia, Candidemia, Sepsis, Endocarditis)

Clinical Indications:

Does this patient need blood cultures?
Reference: Fabre et al. 2020. Does This Patient Need Blood Cultures? A Scoping Review of Indications for Blood Cultures in Adult Nonneutropenic Inpatients. Clinical Infectious Diseases 71:5(1). 1339-1347

Test Includes:

Culture for Bacteria and Yeast

Ordering Alert:

Blood cultures should be collected before administration of antimicrobial agents, therefore may be ordered and collected stat.
Two blood culture sets are recommended for all adult and pediatric patients over 30kg. If endocarditis or endovascular disease is suspected, 3 sets are permitted in a 24-hour period. If more than 3 sets are required, the ordering physician must obtain approval from the site Microbiologist On-Call (MOC) before it is collected.
If fungi (other than yeast/Candida) or non-routine bacterial agents (e.g. Bartonella) from blood cultures are suspected, consult the MOC.
If suspecting Risk Group 3 organisms (e.g. Brucella, Francisella, Yersinia pestis, Burkholderia pseudomallei/mallei, Bacillus anthracis), indicate on the order or notify the MOC or lab before submitting specimens. These organisms pose health risks to lab workers.
Repeat blood cultures within 48 hours of the initial collection are generally not recommended.

Collection Alert:

Do not use contaminated, damaged, or expired bottles
When collecting two blood culture sets, collect from two different venipuncture sites
Always document collection site(s)
Deliver to the laboratory immediately after collection
Greater than 3 sets per 24-hour period requires site Microbiologist-On-Call approval.

Shipping and Handling Alert:

Accurate results depend on the specimen being received in Microbiology laboratory as soon as possible. Blood culture specimens should be sent to the laboratory immediately after collection.
Specimens must be received in the testing laboratory within 4 hours of collection if collected in Calgary, Edmonton, or at a hospital with a Microbiology laboratory, and 24 hours for other collection locations.

LABID (Connect Care):

LAB462

Specimen Source:

Blood, Venous
Blood, Arterial
Blood, Central Line
Blood, Peripheral
Blood, Umbilical Cord
Blood, ECMO

Primary Container:

Aerobic, Anaerobic and Pediatric Blood Culture bottles

Minimum Collection Volume:

Blood Culture collection volumes according to body weight

Patient’s Body Weight	Venipuncture Site 1 (Set 1)	Venipuncture Site 2 (Set 2)	Total volume and number of bottles
Greater than 30 kg (most patients)	Aerobic (10mL) + Anaerobic (10mL)	Aerobic (10mL) + Anaerobic (10mL)	40 mL (4 bottles)
12.8 to 30 kg	Aerobic (10mL) + Anaerobic (10mL)	Aerobic (10mL)	30 mL (3 bottles)
5.1 to 12.7 kg*	Pediatric (4 mL)	Pediatric (2-4 mL)	6 to 8 mL (1 to 2 bottles)
Less than 5.1 kg	Pediatric (minimum 1 mL†)		1 to 4 mL (1 bottle)

*For pediatric patients weighing 5.1 to 12.7 kg a second pediatric bottle can be collected from the same site if the decision is to collect from one site only instead of the recommended 2 sites.
†More blood (up to 4 mL per bottle) can be collected if clinically appropriate.

Specimen Collection Requirements:

See Blood Culture Collection Guideline for detailed instructions.

Venipuncture is the technique of choice for obtaining blood for culture. Arterial blood cultures are not recommended and are not associated with higher diagnostic yields than venous blood cultures.

If other blood work is to be collected, collect the blood culture bottles first.

Do not use contaminated or expired bottles. Check bottles for signs of contamination before use:

Bottle media appears cloudy
Bulging or indented septa, or other signs of gas
For Biomerieux BacT/ALERT bottles: If the bottom of the bottle is bright yellow, it is contaminated

Do not use damaged bottles. Check bottles for signs of damage before use:

Cracked or distended bottles, or bottles that have lost their caps
For BD BACTEC bottles: If the fluorescent material at the base has separated from the glass, it is damaged

In adults and children weighing greater than 30 kg, sets of two blood culture bottles should be drawn from two different venipuncture sites:

Set 1: Collect one aerobic bottle and one anaerobic bottle from the first venipuncture site.
Set 2: From a second venipuncture site (different arm is preferred), collect a second aerobic bottle and anaerobic bottle. If only one arm is available, a different location on the same arm may be used. If a different location on the same arm is not possible, then use of same vein is acceptable.

For suspected catheter-related bloodstream infections, simultaneously collect one set from the catheter and the other from a venipuncture site.
The volume of blood drawn is the most important factor to improve blood culture sensitivity. Fill bottles with adequate blood volume and label correctly. Refer to the following guides, depending on which bottles are available at your site:

BD BACTEC bottles
Biomerieux BacT/ALERT bottles

Test Resources:

Order in Connect Care, or use Community Microbiology Requisition - 20571

When ordering in CC, order using the following smart groups to ensure proper collection:

Blood culture, Routine x 2
Blood culture Panel Adult x3 (Endocarditis)
Blood culture Panel - Pediatric (weight based)

Stability and Storage:

Room temperature. DO NOT refrigerate. DO NOT incubate.

Processing:

Specimens must be received in the testing laboratory within 4 hours of collection if collected in Calgary, Edmonton, or at a hospital with a Microbiology laboratory, and 24 hours for other collection locations.

Transportation:

Deliver to laboratory immediately. Transport at room temperature. Bottles transported via the pneumatic tube system should be packaged with extra padding to ensure bottles do not incur damage due to impacts inside the carrier.

Routine Turn Around Time:

Negative culture: 5 days
(Preliminary Report: 48 hours)

Testing Schedule:

Daily
Blood cultures are monitored continuously for 5 days

Critical Value:

Positive

Testing Area:

Microbiology

Performing Site:

Calgary Diagnostic and Scientific Centre
Chinook Regional Hospital
Edmonton Base Lab
Grande Prairie Regional Hospital
Medicine Hat Regional Hospital
Red Deer Regional Hospital
Northern Lights Regional Health Centre

Last Updated On:

Wednesday, May 21, 2025