Last updated March 15, 2022

Prevention Of Blood Culture Contamination

Decision Options

Standard Procedures

Divert the initial 1–2 ml of blood into a sterile receptacle when drawing blood culture specimens via peripheral venipuncture. (B)
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Use a standard sterile process to draw blood cultures. (B)
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Draw blood cultures from a dedicated peripheral venipuncture site, not an intravenous catheter. (B)
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Use pre-assembled blood culture collection packs. (C)
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Education

Provide education and training for personnel who collect blood cultures. (B)
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Monitor contamination rates and provide performance feedback to personnel who draw blood cultures. (B)
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Personnel

Establish a dedicated staff to draw blood cultures. (B)
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Skin Preparation

Allow the skin cleansing agent to air dry before venipuncture when drawing blood cultures. (A)
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Use chlorhexidine alcohol to clean the skin before drawing blood cultures in patients over 2 months of age. (A)
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Use products containing alcohol to cleanse the skin prior to collecting blood cultures. (A)
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Use alcohol to clean the skin before drawing blood cultures in children under 2 months of age. (C)
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Apply alcohol-containing solutions with 30 seconds of vigorous back and forth scrubbing. If povidone-iodine is used, it should be applied in concentric circles. (C)
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Sterile Gloving

There is inadequate evidence to recommend that routine sterile gloves use was associated with 10% povidone-iodine and cleaned the bottle tops with 70% isopropyl alcohol decrease contamination rates. (I/E)
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Cleaning Culture Bottle Tops

Clean blood culture bottle tops with 70% isopropyl alcohol and air dry prior to blood culture bottle inoculation. (C)
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Blood Volume

Inadequate evidence exists to make a recommendation regarding blood sample volume and prevention of contamination of blood cultures. (I/E)
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Specimen Collection for Intravenous Catheter

There is inadequate evidence to recommend drawing blood cultures from a newly inserted (less than one hour) intravenous catheter with appropriate skin preparation. (I/E)
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Specimen Diversion

Diversion devices reduces in overall blood contamination rates. (B)
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Double Needle Technique

Inoculate the blood culture bottle with a different needle from that used for venipuncture. (B)
Note: Changing needles is not recommended due to the risk of blood exposure.
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Recommendation Grading

Overview

Title

Prevention of Blood Culture Contamination

Authoring Organization

Publication Month/Year

May 8, 2018

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Inclusion Criteria

Female, Male, Adolescent, Adult, Child, Infant, Older adult

Health Care Settings

Emergency care, Hospital

Intended Users

Nurse, laboratory technician, nurse practitioner, physician, physician assistant

Scope

Prevention

Diseases/Conditions (MeSH)

D000071997 - Blood Culture

Keywords

blood culture, contamination