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Culture & Sensitivity, Aerobic bacteria Blood 2 Aerobic-2 Anaerobic (Manual method)
Bacterial/ Viral
Report in 78Hrs
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No Fasting Required
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Identifies bacteria & antibiotic susceptibility.
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Culture & Sensitivity Aerobic bacteria Blood 2 Aerobic-2 Anaerobic (Manual method)
- Why is it done?
- Identifies bacterial pathogens present in bloodstream infections (bacteremia or sepsis)
- Determines antibiotic susceptibility patterns to guide targeted antimicrobial therapy
- Cultures both aerobic and anaerobic organisms from two separate blood culture bottles using manual inoculation method
- Ordered when patients present with fever, sepsis, endocarditis, or other signs of systemic infection
- Essential for hospitalized patients with unexplained fever or hemodynamic instability
- Typically performed before initiating empiric antibiotic therapy to optimize treatment selection
- Normal Range
- Normal Result: No growth - negative culture after 5 days of incubation
- Abnormal Result: Growth of bacterial organism(s) - positive culture
- Units of Measurement: Growth reported as organism identification (genus/species) with time to positivity
- Sensitivity Results: Reported as Susceptible (S), Intermediate (I), or Resistant (R) to tested antibiotics
- Incubation Period: Minimum 5 days for aerobic and anaerobic bacteria; manual method may require up to 7 days for final results
- Interpretation
- Negative Culture (No Growth): Indicates absence of bacteremia; blood is sterile and free from bacterial contamination; may occur in non-infectious causes of fever
- Positive Culture - Aerobic Bacteria: Clinically significant bacteremia; aerobic organisms include Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli, Klebsiella, Pseudomonas aeruginosa; requires immediate clinical intervention
- Positive Culture - Anaerobic Bacteria: Indicates anaerobic bacteremia; organisms include Bacteroides fragilis, Clostridium species, Peptostreptococcus; often associated with intra-abdominal infections or procedure complications
- Time to Positivity: Early positivity (hours) suggests high-grade bacteremia; delayed positivity may indicate environmental contamination or low bacterial load
- Susceptibility Interpretation - Susceptible (S): Antibiotic is effective; organism likely to respond to therapy at recommended dosages
- Susceptibility Interpretation - Intermediate (I): Variable clinical efficacy; treatment may be effective at higher dosages or tissue concentrations; alternative agents often preferred
- Susceptibility Interpretation - Resistant (R): Antibiotic ineffective; organism unlikely to respond; alternative agents must be selected
- Contamination vs. True Infection: Skin commensals in single bottle suggest contamination; growth in both bottles or known pathogens indicates genuine bacteremia
- Manual Method Advantages: Allows for direct visualization and subculturing from media; useful for fastidious organisms; requires regular manual inspection and handling
- Associated Organs
- Primary Systems Affected: Cardiovascular system, immune system, and multiple organ systems affected by systemic infection
- Endocarditis: Blood culture essential for diagnosis; positive results indicate heart valve infection; major Duke criterion for diagnosis
- Sepsis/Septic Shock: Positive blood cultures confirm sepsis diagnosis; guides antimicrobial therapy; critical for mortality reduction
- Pneumonia with Bacteremia: Respiratory tract infection spreading to bloodstream; indicates severity and need for hospitalization
- Urinary Tract Infections with Sepsis: Urosepsis with positive blood cultures indicates ascending infection; high-risk condition requiring immediate intervention
- Intra-abdominal Infections: Peritonitis or abscesses; anaerobic organisms often identified; may require surgical intervention
- Meningitis: Positive blood cultures in 40-60% of bacterial meningitis cases; guides CSF culture interpretation
- Immunocompromised Patients: Increased risk for opportunistic infections; both aerobic and anaerobic cultures critical; higher contamination concerns
- Central Line-Associated Bloodstream Infections (CLABSI): Positive blood cultures; medical device-related infections; major cause of nosocomial bacteremia
- Follow-up Tests
- Repeat Blood Cultures: Obtained 24-48 hours after initiating therapy to assess treatment response and clearance of bacteremia
- Cerebrospinal Fluid (CSF) Culture: If meningitis suspected; same organisms often isolated from blood and CSF
- Urine Culture: If urinary source suspected; identifies causative organism for urinary tract involvement
- Wound or Abscess Culture: If localized infection source identified; both aerobic and anaerobic coverage needed
- Echocardiography: If endocarditis suspected; visualizes vegetations on heart valves; essential for Duke criteria confirmation
- Complete Blood Count (CBC): Assesses white blood cell response to infection; evaluates for sepsis-related changes
- Procalcitonin/C-Reactive Protein (CRP): Inflammatory markers; may guide antibiotic de-escalation decisions
- Blood Chemistry Panel: Evaluates organ dysfunction and metabolic derangements associated with sepsis
- Imaging Studies (CT/MRI): If primary infection source not identified; helps locate abscess or source of bacteremia
- Susceptibility-Guided Therapy: Results direct antibiotic de-escalation or escalation within 24-48 hours of culture results
- Fasting Required?
- Fasting Required: NO
- Patient Preparation: No dietary restrictions; blood collection can be performed at any time regardless of meal status
- Collection Timing: Optimal collection before antibiotics initiated; can be collected any time of day; multiple sets recommended (2-3 sets from different sites)
- Skin Antisepsis: Chlorhexidine or povidone-iodine; allow skin to dry completely (15-30 seconds) to prevent dilution and contamination
- Medications: No medications need to be withheld; ideal to collect before starting antibiotics; if antibiotics already initiated, inform laboratory as this affects culture results interpretation
- Collection Volume: 10 mL per bottle for aerobic culture; 10 mL per bottle for anaerobic culture; adequate volume essential for optimal culture recovery
- Special Instructions: Collect from peripheral venipuncture preferred over arterial lines or catheters; use sterile technique throughout; label bottles clearly with collection time and site; notify laboratory of central line collection if used
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