Blood Cultures

The contamination rate of blood cultures (BC) taken on the ACCU is very high with approximately 50% of all positive cultures being coagulase negative staphylococcus aureus. Blood cultures should be taken as per the Trust guidelines from a peripheral stab (http://bartshealthintranet/AboutUs/CorporateDirectorates/MedicalDirectorate/Infectionpreventionandcontrol/Index.aspx).

When undertaking a septic screen, blood cultures should normally be taken from a peripheral stab only. Ensure they are labelled as peripheral on the request.

Blood cultures can be taken from NEWLY inserted CVCs and labelled as a peripheral stab (as they effectively  are equivalent).

Line cultures to be taken only in exceptional circumstances (consultant request, suspected sepsis in tunnelled line, impossible venesection) and only from central vascular access not arterial. Label these as being taken from a central line.

CVC tips should only be sent for culture if we are suspecting line sepsis / have changed the line for suspected line sepsis.

If taking more than one set of blood cultures, request them for different times so that they appear separately on CRS results.

Do not take blood cultures from existing arterial lines except in exceptional circumstances (a significant proportion of blood cultures positive for skin commensals are taken from arterial lines, reflecting contamination. Arterial lines are extremely rarely a source of CLABSI.)

Clean skin (or bionector access port if taking from central access) thoroughly with 2% chlorhexidine and allow to dry.
Clean the top of the blood culture bottles with 2% chlorhexidine and allow to dry.
Maintain non-touch technique when taking sample.