Skip to main content



This educational webpage is based on the Blood Culture Educational Booklet that you can access HERE.

Please note that by clicking on a link you will be redirected outside bioMérieux's website.

1.  CLSI. Principles and Procedures for Blood Cultures. 2nd ed. CLSI guideline M47. Clinical and Laboratory Standards Institute; 2022

2.  Rudd KE, Johnson SC, Agesa KM, et al. Global, regional, and national sepsis incidence and mortality, 1990 – 2017: analysis for the Global Burden of Disease Study. Lancet. 2020;395(10219):200–211

3.  WSD fact sheet 2020. Accessed Nov 8th 2021

4.  Kumar A, Ellis P, Arabi Y, et al. Initiation of inappropriate antimicrobial therapy results in a fivefold reduction of survival in human septic shock. Chest. 2009;136(5):1237-1248

5.  Singer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810

6.  European Society for Clinical Microbiology and Infectious Diseases, European Manual for Clinical Microbiology, 1st Edition, 2012

7.  Garey KW, Rege M, Pai MP, et al. Time to Initiation of Fluconazole Therapy Impacts Mortality in Patients with Candidemia: A Multi-Institutional Study. Clin Infect Dis. 2006;43(1):25-31

8.  Khatib R, Saeed S, Sharma M, et al. Impact of initial antibiotic choice and delayed appropriate treatment on the outcome of Staphylococcus aureus bacteremia. Eur J Clin Microbial Infect Dis. 2006;25(3):181-185

9.  Kollef MH, Sherman G, Ward S, Fraser VJ.  Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients. Chest. 1999;115(2):462-474

10.  Harbarth S, Garbino J, Pugin J, et al. Inappropriate initial antimicrobial therapy and its effect on survival in a clinical trial of immunomodulating therapy for severe sepsis. Am J Med. 2003;115(7):529–535

11.  Lodise TP, McKinnon PS, Swiderski L, Rybak MJ. Outcomes Analysis of Delayed Antibiotic Treatment for Hospital-Acquired Staphylococcus aureus Bacteremia. Clin Infect Dis. 2003;36(11):1419-1423

12.  Kang CI, Kim SH, Kim HB, et al. Pseudomonas aeruginosa bacteremia: risk factors for mortality and influence of delayed receipt of effective antimicrobial therapy on clinical outcome. Clin Infect Dis. 2003;37(6):745-751

13.  Forrest GN, Mankes K, Jabra-Rizk MA, et al. Peptide Nucleic Acid Fluorescence In Situ HybridizationBased Identification of Candida albicans and Its Impact on Mortality and Antifungal Therapy Costs.  J Clin Microbiol. 2006;44(9):3381–3383

14.  Kumar A, Roberts D, Wood KE, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med. 2006;34(6):1589-1596

15.  Evans L, Rhodes A, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Crit Care Med. 2021;49(11):e1063-e1143

16.  Shapiro NI, Wolfe RE, Wright SB, et al. Who needs a blood culture? A prospectively derived and validated prediction rule. J Emerg Med. 2008;35(3):255-64

17.  Baron EJ, Weinstein MP, Dunne Jr. WM, et al. Cumitech 1C, Blood Cultures IV. Coordinating ed., E.J. Baron. ASM Press, Washington, D.C. 2005

18.  Scheer CS, Fuchs C, Gründling M, et al. Impact of antibiotic administration on blood culture positivity at the beginning of sepsis: a prospective clinical cohort study. Clin Microbiol Infect. 2019;25(3):326-331 

19.  Mermel LA, Maki DG. Detection of bacteremia in adults : consequences of culturing an inadequate volume of blood. Ann Intern Med. 1993;119(4):270-272

20.  Bouza E, Sousa D, Rodríguez-Créixems M, et al. Is the volume of blood cultured still a significant factor in the diagnosis of bloodstream infections? J Clin Microbiol. 2007;45(9):2765-2769

21.  Carroll KC, Pfaller MA, Landry ML, et al. Manual of Clinical Microbiology, 12th Edition, 2019

22.  Cockerill FR III, Wilson JW, Vetter EA, et al. Optimal testing parameters for blood cultures. Clin Infect Dis. 2004;38 :1724-1730

23.  Kellogg JA, Manzella JP, Bankert DA. Frequency of low-level bacteremia in children from birth to fifteen years of age. J Clin Microbiol. 2000;38(6):2181-2185

24.  Huber S, Hetzer B, Crazzolara R, Orth-Höller D. The correct blood volume for paediatric blood cultures: a conundrum? Clin Microbiol Infect. 2020;26(2):168-173

25.  Freedman SB, Roosevelt GE. Utility of anaerobic blood cultures in a pediatric emergency department. Pediatr Emerg Care. 2004;20(7):433-436

26.  Lee A, Weinstein MP, Mirrett S, Reller LB. Detection of Bloodstream Infections in Adults: How Many Blood Cultures Are Needed ? J Clin Microbiol. 2007;45(11):3546-3548

27.  Lee DH, Kim SC, Bae IG, et al. Clinical Evaluation of BacT/ALERT FA Plus and FN Plus Bottles Compared with Standard Bottles. J Clin Microbiol. 2013;51(12):4150-4155

28.  Amarsy-Guerle R, Mougari F, Jacquier H, et al. High medical impact of implementing the new polymeric bead-based BacT/ALERT® FA Plus and FN Plus blood culture bottles in standard care.  Eur J Clin Microbiol Dis. 2015;34(5):1031-1037

29.  Kirn TJ, Mirrett S, Reller LB, Weinstein MP, Controlled Clinical Comparison of BacT/ALERT FA Plus and FN Plus Blood Culture Media  with BacT/ALERT FA and FN Blood Culture Media. J Clin Microbiol. 2014;52(3):839-843

30.  Doern C, Mirrett S, Halstead D, et al. Controlled Clinical Comparison of New Pediatric Medium with Adsorbent Polymeric Beads (PF Plus) versus Charcoal-Containing PF Medium in the BacT/ALERT Blood Culture System. J Clin Microbiol. 2014;52(6):1898-1900

31.  Riley JA, Heiter BJ, Bourbeau P.P. Comparison of recovery of blood culture isolates from two BacT/ ALERT FAN aerobic blood culture bottles with recovery from one FAN aerobic bottle and one FAN anaerobic bottle. J Clin Microbiol. 2003;41(1):213-217

32.  Weinstein MP, Towns ML, Quartey SM, et al. The clinical significance of positive blood cultures in the 1990s; a prospective comprehensive evaluation of the microbiology, epidemiology, and outcome of bacteremia and fungemia in adults. Clin Infect Dis. 1997;24(4):584–602

33.  UK Department of Health : Taking Blood Cultures – A summary of best practice. 2007

34.  Wilson ML, Mirrett S, Reller LB, et al. Recovery of clinically important microorganisms from the BacT/ ALERT blood culture system does not require testing for 7 days. Diagn Microbiol Infect Dis. 1993;16(1):31-34

35.  Bourbeau PP, Foltzer M. Routine incubation of BacT/ALERT FA and FN blood culture bottles for more than 3 days may not be necessary. J Clin Microbiol. 2005;43(5):2506-2509

36.  Rubin LG.  2012.  Other Gram negative coccobacilli, In Principles and Practice of Pediatric Infectious Diseases, 4th Ed.  Long, SS, Pickering LK, and Prober CG, eds.  Elsevier, p 939-941

37.  Hall KK and Lyman JA. Updated review of blood culture contamination. Clin Microbiol Rev. 2006;19(4):788-802 26 27 REFERENCES

38.  Bamber AI, Cunniffe JG, Nayar D, et al. The effectiveness of introducing blood culture collection packs to reduce contamination. Br J Biomed Sci. 2009;66(1):1-9

39.  Gander RM, Byrd L, DeCrescenzo M, et al. Impact of blood cultures drawn by phlebotomy on contamination rates and health care costs in a hospital emergency department. J Clin Microbiol. 2009;47(4):1021-1024

40.  Richter SS, Beekman SE, Croco DJ, et al. Minimizing the workup of blood culture contaminants: implementation and evaluation of a laboratory-based algorithm. J Clin Microbiol. 2002;40(7):2437-2444

41.  Towns ML, Reller LB. Diagnostic methods : current best practices and guidelines for isolation of bacteria and fungi in infective endocarditis. Infect Dis Clin N Am. 2002;16(2):363-376

42.  Osborn TM, Nguyen HB, Rivers EP. Emergency medicine and the surviving sepsis campaign: an international approach to managing severe sepsis and septic shock. Ann Emerg Med 2005;46:228-231

43.  Ellis ME, Al-Abdely H, Standridge A, et al. Fungal endocarditis: evidence in the world literature, 19651995. Clin Infect Dis. 2001;32(1):50-62

44.  Badiee P, Amirghofran AA, Nour MG, et al. Incidence and outcome of documented fungal endocarditis. Int Cardiovasc Res J. 2014;8(4):152-155

45.  Pasha AK, Lee JZ, Low S-W, et al. Fungal Endocarditis - Update on Diagnosis and Management. Am J Med. 2016;129(10):1037-1043

46.  Baron EJ, Scott JD, Tompkins LS. Prolonged incubation and extensive subculturing do not increase recovery of clinically significant microorganisms from standard automated blood cultures. Clin Infect Dis. 2005;41(11):1677-1680

47.  Beekmann SE, Diekama DJ, Chapin KC, Goern GV. Effects of rapid detection of bloodstream infections on length of hospitalization and hospital charges. J Clin Microbiol. 2003;41(7):3119-3125

48.  Munson E, Diekema DJ, Beekmann SE, et al. Detection and treatment of bloodstream infection: laboratory reporting and antimicrobial management. J Clin Microbiol. 2003;41(1):495-497

49.  Barenfanger J, Graham DR, Kolluri L, et al. Decreased Mortality Associated With Prompt Gram Staining of Blood Cultures. Am J Clin Pathol. 2008;130(6):870-876

50.  Timbrook T, Boger MS, Steed LL, Hurst JM. Unanticipated Multiplex PCR Identification of Polymicrobial Blood Culture Resulting in Earlier Isolation, Susceptibilities, and Optimization of Clinical Care. J Clin Microbiol. 2015;53(7):2371-2373  

51.  Bauer KA, West JE, Balada-Llasat J, et al. An Antimicrobial Stewardship Program’s Impact with Rapid Polymerase Chain Reaction Methicillin-Resistant Staphylococcus aureus / S. aureus Blood Culture Test in Patients with S. aureus Bacteremia. Clin Infect Dis. 2010;51(9):1074-1080

52.  Dierkes C, Ehrenstein B, Siebig S, et al. Clinical impact of a commercially available multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis. BMC Infect Dis. 2009;9(1):126

53.  CLSI. Performance Standards for Antimicrobial Susceptibility Testing. 32nd ed. CLSI supplement M100. Clinical and Laboratory Standards Institute; 2022

54.  Jonasson E, Matuschek E, and Kahlmeter G. The EUCAST rapid disc diffusion method for antimicrobial susceptibility testing directly from positive blood culture bottles. J Antimicrob Chemother. 2020;75:968–978

55.  Tibbets R, George S, Burwell R, et al. Performance of the Reveal Rapid Antibiotic Susceptibility Testing System on Gram-Negative Blood Cultures at a Large Urban Hospital. J Clin Microbiol. 2022;60(6):e0009822

56.  Weinstein MP. Blood Culture Contamination: Persisting Problems and Partial Progress. J Clin Microbiol. 2003;41(6):2275-2278

57.  Doern GV, Carroll KC, Diekema DJ. Practical Guidance for Clinical Microbiology Laboratories: A Comprehensive Update on the Problem of Blood Culture Contamination and a Discussion of Methods for Addressing the Problem. Clin Microbiol Rev. 2019;33(1):e00009-19

58.  Applied Phlebotomy. Dennis J. Ernst, Dennis J. Ernst (MT(ASCP)). Lippincott Williams & Wilkins, 2005

59.  Essentials Of Medical Laboratory Practice. Constance L Lieseke, Elizabeth A Zeibig. F.A. Davis, 2012

60.  Qamruddin A, Khanna N, Orr D. Peripheral blood culture contamination in adults and venipuncture technique: prospective cohort study. J Clin Pathol. 2008;61(4):509-513 

The content on this website and associated materials do not constitute medical advice and should not be considered a substitute for the individual professional judgement of any physician or other health care practitioner regarding the appropriate course of action for a particular patient. All recommendations should be independently reviewed with appropriate medical staff in light of the needs of any particular institution and its patients. bioMérieux makes no guarantee or representation regarding the accuracy, completeness, or usefulness of this information for any particular purpose, including but not limited to any cost savings.