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Announcements : 02/09

Effective February 15, 2009

Blood Culture Reporting Changes

The following changes in extent of identification and susceptibility testing have been added to the Blood Culture procedure in Microbiology. These changes were made in accordance with recommendations from the American Society of Microbiology (ASM) and the Infectious Disease Society of America (IDSA). The purpose of these changes is to minimize the potential for patient treatment due to blood culture contaminates. The cost of a contaminated blood culture can add approximately $4,000.00 in unnecessary patient care.

These changes have been developed in collaboration with the Division of Infectious Diseases and have been approved by the Inpatient Steering Committee at Froedtert Memorial Lutheran Hospital. Please see the table below highlighting the new procedure. These changes affect only the organisms listed in the table below.

ORGANISM	# OF CULTURES POSITIVE WITHIN 7DAYS	LEVEL OF IDENTIFICATION	ANTIMICROBIAL SUSCEPTIBILITY TESTING PERFORMED
Coagulase Negative Staphylococcus	Single Culture	Reported as Coagulase Negative Staphylococcus	No
Coagulase Negative Staphylococcus	Multiple Cultures	Identify to species level	If same species, susceptibilities are performed If different species, no susceptibilities
*Streptococcus* viridans group	Single Culture	Report as Streptococcus viridans group	No
*Streptococcus* viridans group	Multiple Cultures	Identify to species level	Yes
*Corynebacterium* species	Single Culture	Identify to genus level	No
*Corynebacterium* species	Multiple Cultures	Identify to genus level If resistant susceptibility pattern, rule out Corynebacterium jeikeium	Yes
*Lactobacillus* species	Single or Multiple	Report to genus or species level	No
*Bacillus* species	Single Culture	Identify to genus level Rule out Bacillus anthracis	No
*Bacillus* species	Multiple Cultures	Identify to Genus Rule out Bacillus anthracis	Only by request

Organisms such as Gram negative bacilli, Staphylococcus Coagulase Positive, Enterococcus species, etc. will continue to be tested and reported as they have been in the past, which in most cases means full identification (to species level where applicable) and susceptibility testing.
Yeast isolates will continue to be identified to species level where possible, with susceptibility testing performed once per isolate.
Mold isolates will continue to be identified to species level where possible. Susceptibility testing is performed only upon request.
Anaerobic bacterial isolates will continue to be identified to species level where possible. Beta Lactamase testing is performed where appropriate. Additional susceptibility testing is performed only upon request.

ORGANISM