AFB Blood Culture
Label Mnemonic: AFBBL
Epic code: LAB246
Downtime form: A-1a Doctor-Provider Orders - Pathology Microbiology
Microbiology
BT 6004
356-2591 Bacteriology/Virology Section
Specimen(s):
Blood
Specimen Instructions:
5 mL (maximum) per bottle
Collection Medium:
Myco/F Lytic Bottle - available from the Microbiology Laboratory
Testing Schedule:
24 hrs/day, 7 days a week, including holidays.
Turn Around Time:
6 weeks
Comments:
Myco/F Lytic vials are not routinely used for blood culture as 
routine blood cultures are effective for most pathogens.  Yield of 
culture is critically affected by the volume of blood drawn: at 
minimum, THREE bottles from 2 venipunctures and ideally SIX bottles 
from 3 venipunctures should be obtained.  Each bottle should be filled 
with 5 mL of blood.  Bottles are available from the Microbiology 
laboratory (356-2591).

The following guidelines were developed specifically for the diagnosis 
of M. chimaera endovascular infection, where bacterial loads are 
likely high.

1. Order one "AFB Blood Culture R/O Mycobacterium chimaera" in 
EPIC for each venipuncture (LAB8454).  Obtain Isolator tubes 
sized for pediatric patients (1.5 mL) or adults (10 mL) from Hospital 
Stores or nearby clinic area if in stock.
   •1.5 mL; pediatric Isolator blood culture tube 
    (Hospital Stores 923003)
   •10 mL; adult Isolator blood culture tube 
    (Hospital Stores 922848)

2. Follow instructions in Nursing policy N-03.020 Blood Culture 
Collection, Adult or PHL-06 Phlebotomy 	protocol for antisepsis and 
drawing blood.

3. ADULTS with suspected mycobacterial endocarditis: 
collect 2 venipunctures (2 orders total) with 1 Isolator tube per 
venipuncture site.  An additional Isolator tube may be drawn to 
maximize diagnostic yield (3 orders total).

PEDIATRIC patients with suspected mycobacterial 
endocarditis: obtain 1 or 2 venipunctures and pediatric and/or adult-
sized Isolator tubes as below:
    -----------------------------------------------------------
     AGE (years)   10 mL Tubes to Fill    1.5 mL Tubes to Fill
          1                None            1 (1 venipuncture)
          2                None            1 (1 venipuncture)
          3                None            2 (2 venipunctures)
          4        1 (1 venipuncture)              None
          5        1 (1 venipuncture)              None
     6 and above   2 (2 venipunctures)             None
    -----------------------------------------------------------

4. Inoculate either 1.5 mL or 10 mL into each Isolator tube: tubes 
MUST be full as over-concentrated substances within the tubes are 
toxic to bacteria.

5. Send to Microbiology laboratory; call 356-2591 with questions.
CPT Code:
87116
 
See Additional Information:
Phlebotomy Team Policies