BLOOD CULTURE GUIDELINES FOR NEUTROPENIC PATIENTS
revised January 2002; reviewed January 2005
See also UWHC
Blood Culture Guidelines
Initial cultures when temperature > 38.2
For first fever spike, send 2 blood cultures (1 peripheral and 1 central
line). Obtain a U/A and culture, CXR (AP/lat preferred) if not done
in past 24 hours, and sputum culture if patient is able to produce one.
If venipuncture not possible or unfeasible: obtain cultures from two separate
lumens of catheter
After 24 hours, if patient remains febrile or has another temperature spike,
culture one port (culture opposite port from previous day) and one peripheral
site. If venipuncture unfeasible, culture from two separate lumens
On the third day of persistent fever, reculture from one port and one peripheral
If the patient is febrile more than 3 consecutive days and all previous
cultures have been negative, base decisions on future cultures on the patientís
clinical status. Daily cultures are not required if the patient's
clinical status is unchanged.
If 48 hours have elapsed since the last documented fever, treat as a first
time fever spike.
Cultures for coagulase negative staph (gram positive cocci in clusters):
treat only if two cultures from different sites are positive, or if there
are clear signs or symptoms to suggest line infection; otherwise reculture.