Laboratory Test Information Guide

Details for Blood Culture – Aerobic/Anaerobic (Paediatric)

Test Name: Blood Culture – Aerobic/Anaerobic (Paediatric)
Alternate Name(s):  
Laboratory: Microbiology
Specimen Type: Blood
Collection Information: This sample type cannot be processed as a STAT request. Results are reported as they become available.

Indications
Blood cultures should be collected on each patient based on the clinical suspicion of a septic episode. The number of cultures to collect will vary between one or two separate collections within a 24-hour period.

A paediatric blood culture set may consist of an aerobic bottle only or an aerobic + anaerobic bottle. An aerobic set consists of 1 aerobic blood culture bottle; depending on patient weight 1-2 sets may be required. An aerobic + anaerobic set consists of 1 aerobic and 1 anaerobic blood culture bottle with 1-2 sets required based on patient weight (see Table Recommended number of blood culture sets/distribution of blood). Each blood culture set must be ordered separately.

Anaerobic blood cultures
Anaerobic blood cultures may be considered in patients with a known/suspected intra-abdominal infection, deep head and neck infection, or immunosuppression. For neonatal patients, anaerobic cultures may also be considered for patients on probiotics.

Blood cultures for Candida species
No additional procedures are required for the routine isolation of Candida species from the blood.

Blood cultures for the fungal organisms Malassezia species, Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides immitis
Cultures directed at Malassezia spp. may be considered in patients within the NICU/PCCU on parenteral lipid therapy, in the absence of positive routine cultures. Alternative collection procedures are required for the isolation of this organism.

Please refer to Laboratory Test Information Guide: Blood culture - Malassezia species, Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides immitis.

Blood sampling volumes
The appropriate blood volume to collect in children is dependent on weight; weight based procedures allow for safe collection, while optimizing detection of bloodstream infections. For patients weighing more than 35 kg, consider 2-sets of blood cultures with aerobic and anaerobic cultures following the routine adult collection guidelines Please refer to Blood Culture – Aerobic/Anaerobic (adult).

For patients weighing less than 35 kg, please refer to the Recommended Number of Blood Culture Sets/Distribution of Blood in Paediatric Patients.

Note: Each set should be ordered separately.

*Caution* There is a strong draw on these bottles. Do not overfill or underfill.
Red top bottles have special gases inside; do not vent or introduce air from the syringe into the bottle.

Site selection (if applicable)
Each blood culture set, if applicable, should be drawn from a different draw – 2 different venipuncture sites OR 1 venipuncture site plus 1 central line site.

Central lines
For the purpose of blood culture collection, the initial draw (‘waste’) from a central line may be used in the collection process for the purposes of blood culture.

For central lines with multiple lumens, it is recommended to either draw from each lumen (and record in EPR the lumen sampled) or pool blood from multiple lumens into one blood culture bottle. Regardless of the chosen procedure, each lumen should be sampled.

Labelling
Each paediatric blood culture must have a new order with a separate distinguishable accession number. When blood culture bottles are collected in a set (2 bottles – Aerobic/Anaerobic), they must have the same accession number. Affix one large collection label to each of the bottles in the space provided at bedside.

Send all remaining labels in the specimen bag with the blood culture bottle/set.
Place labels vertically. Do not cover the bottle bar code. Transport as directed.

Additional information can be found at: Blood culture collection procedure – Labelling and Transport.

Collection procedures
Please refer to the blood culture collection procedures:
Blood culture collection procedure – Paediatric, Venipuncture
Blood culture collection procedure – Central line
Requisition: MICROBIOLOGY REQUISITION
Test Schedule: Daily
Turnaround time from when specimen
is received in testing laboratory:
 
Routine
5 days – positive findings are available within 1 hour of discovery. Negative cultures at 24 hour
Stat
N/A
 
Reference Range:  5 days – positive findings are available within 1 hour of discovery.

Negative cultures at 24 hours will be routinely updated with the comment “No growth 1 day”.
Effective Date: 2018-04-09
Revised Date:  
Critical Value:  
Interpretive Comments: Recovery of organisms depends mainly on volume of blood collected and frequency of collection. Timing is less important, particularly if cultures are collected before antimicrobial therapy.
Special Processing:  
Comments:  
Method of Analysis: Continuous monitoring blood culture system
Critical Information Required:  
Storage & Shipment: Transport bottle to the lab promptly; all bottles must be received within 24 hours of collection. Please see Blood culture transportation to Lab for proper transport.

If there is a delay in transport, bottles can be left at room temperature. Never refrigerate. Additional information can be found at: Blood culture collection procedure – Labelling and Transport.
System Codes: 
Cerner
BLC
 
Referred To:  

Questions? Comments? Contact Laura Gopaul