Test Code FBCUL 
Methodology Bactec 9000® / Blind Subcultures
Includes "Culture, Bacteria, Blood." 
Description Fungal Isolates reflex to organism identification. Bacterial isolates reflex to organism identification and antibiotic susceptibility test. Additional charges apply. 
Specimen Collect specimen using the following procedure:
1. Remove plastic caps from Bactec® blood culture bottles and place an alcohol prep on top of the exposed rubber. DO NOT USE BETADINE.
2. Apply tourniquet and locate the vein. Release the tourniquet during skin preparation.
3. Hold Mediflex® Frepp® sponge (70% isopropyl alcohol) in a horizontal position and pinch handle once to break ampoule. Do not continue to squeeze handle. Place sponge on venipuncture site and depress once or twice to saturate sponge. Scrub vigorously for 60 seconds and allow to dry.
4. Hold Mediflex® Sepp® ampoule (2% iodine tincture) in downward position and pinch center of Sepp® to crush ampoule. Apply to venipuncture site starting at the center and moving outward in concentric circles.
5. Allow the prepared site to air dry at least 30 seconds. This will ensure that the iodine is allowed adequate time to disinfect the skin.
6. Re-apply the tourniquet.
7. Do not repalpate or touch the venipuncture site after it has been prepared.
8. Perform venipuncture using aseptic technique and a sterile syringe with an adequately gauged needle. The recommended draw for a single blood culture follows:

Patient Age Amount of Blood
< 12 months ------- 2 - 3 mL
12 - 24 months ---- 3 - 5 mL
2 - 9 years --------- 5 - 8 mL
>= 10 years ------ 16 - 20 mL

9. Release tourniquet.
10. Withdraw needle.
11. Apply gauze. Do not allow gauze to touch needle during withdrawal.
12. Apply pressure to puncture site.
13. Inoculate appropriate bottles with volumes listed in the following table. It is not necessary to change needles between collection and inoculation.

Amount of Blood = > 10 mL:
Anaerobic Bottle - Half
Aerobic Bottle - Half

Amount of Blood = 5 - 10 mL:
Aerobic Bottle - All

Amount of Blood = < 5 mL:
Pediatric Bottle - All

14. Using an alcohol swab, thoroughly clean all vial tops following inoculation of specimen.
15. Label bottles with patient's name (first and last), date of birth or medical record number, date and time of collection, collector's initials and specimen source.
16. Maintain bottles at ambient temperature and deliver promptly. 

Reference Values No growth (Positive culture is a critical value with auto call-back.) 
Analytic Time Positives are reported when detected. Negatives are reported in 6 Days 
Day(s) Test Set Up Monday through Sunday 
CPT Code(s) 87077  Bacterial identification, if indicated
87103  Blood fungus culture
87106  Fungus identification, if indicated
87149 x5  CRE Confirmation, if indicated
87181  Antibiotic susceptibility (gradient strip), per antibiotic tested, if indicated
87184  Antibiotic susceptibility (disc method), if indicated
87186  Antibiotic sensitivity (MIC), if indicated