- Collection of Specimens for Blood Culture
- Preparation: Proper specimen collection is essential to minimize contamination. Clean venipuncture site with 70% isopropyl ethyl alcohol. Apply tincture of iodine or 10% povidone-iodine and allow to dry for at least 1 min, or scrub site with 2% chlorhexidine for 30 seconds and allow to dry for 30 seconds for dry sites, scrub for 2 minutes and allow to dry for 1 minute for moist sites. Clean blood culture bottle injection site with alcohol only
- Collection: Ideally, two sets of cultures of equal blood volume should be obtained for each febrile episode, based on patient weight: <8 kg, 1–3 mL each; 8–13 kg, 4–5 mL; 14–25 kg, 10–15 mL each; >25 kg, 20–30 mL each (adapted from Kaditis et al., 19961). Total blood volume drawn should not exceed more than 1% of the patient's total blood volume
- Rapid Microbiologic Identification of Common Aerobic Bacteria (Fig. 17-1)
- Choosing Appropriate Antibiotic Based on Sensitivities
- Minimum inhibitory concentration (MIC): Lowest concentration of an antimicrobial agent that prevents visible growth after an 18- to 24-hour incubation period
- Minimum bactericidal concentration (MBC): Lowest concentration of an antimicrobial agent that kills the organism, as measured by subculturing to antibiotic-free media after 18- to 24-hour incubation
- Mistakes to avoid when selecting antibiotics based on sensitivity profiles (Table 17-1): Clinically significant, common discrepancies between in vitro (laboratory reported) and in vivo antibiotic sensitivity profiles that may result in inappropriate antibiotic treatment
FIGURE 17-1 Algorithm demonstrating identification of aerobic bacteria. Numbers in parentheses indicate the time required for the tests.
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