Blood specimens

Prompt, adequate, and aseptic collection of blood for culture before starting antimicrobial therapy is essential to identify the causative pathogen in septic shock and to guide antimicrobial therapy. Blood is best collected by direct venipuncture with a needle and syringe or a sterile transfer set. Specimens collected from arterial or venous access catheters may only demonstrate colonization of the catheter and not septicemia. Vascular catheter tips should be submitted for culture when removed.

Bacteremia is best demonstrated by detecting the same organism in multiple blood cultures collected over several hours from different venipuncture sites ( Murray. 1995). If it is not possible to delay antimicrobial therapy beyond the initial set of cultures, two culture sets from different venipuncture sites can be collected. Collection times should be clearly noted to assess the relationship between clinical condition, antimicrobial therapy, procedures performed, and culture results.

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