Automated blood culture systems have made bacteremia much easier to detect. The current systems use a prepared bottle that has responds to the growth of bacteria to induce an observable change. These systems use color, pressure change, or chemical change to detect the growth of bacteria in the inoculated bottle. These automated systems require a ratio of blood to medium between 1:10 and 1:5. If the volume of blood is too low there may not be enough colony forming units for detection. And if the ratio goes below 1:5 blood components may not be diluted enough and may inhibit bacterial growth. A study performed at China Medical University Hospital in Taichung, Taiwan1 showed the effects that blood volume can have on detection of bacteremia. Hsiu-Hsien et. al. performed this study were they retrained the ER department where 97% of blood cultures were done with less than 5mL of blood and after training greater than 70% of blood cultures were done with at least 5mL of blood. In this study, it is evident that the amount of blood used has great impact on the recovery of organisms. They showed that with blood volumes of 5-10 ml that recovery increased by 17% over low volumes. Volumes greater than 10mL showed lower recovery rates than smaller volumes.
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1 Hsiu-Hsien Lin et.al. Evaluation of the blood volume effect on the diagnosis of bacteremia in automated blood culture systems Journal of Microbiology, Immunology and Infection (2013) 46, 48-52 Http://www.sciencedirect.com/science/article/pii/S1684118212000503
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