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Blood culture: Mycobacteria (bone marrow m.chimaera chimaera miliary disseminated afb aafb mycobacterium)

Microbiology

Notes

  • Mycobacterial blood culture is restricted to the investigation of specific conditions:
  • Tuberculous bone marrow infection (when bottle is inoculated with a bone marrow aspirate)
  • Suspected miliary Mycobacterium tuberculosis infection
  • Suspected disseminated atypical mycobacterial infection (eg Mycobacterium avium complex), usually in the context of severe immunosuppression, such as HIV infection
  • Suspected disseminated BCG infection following intravesical treatment using BCG for treatment of bladder cancer
  • Investigation of disseminated Mycobacterium chimaera infection or endocarditis associated with cardiopulmonary bypass
  • Note: The sample of choice for M. chimaera sternal wound infection is a tissue culture of a sternal wound biopsy (tissue or bone) or pus. Swab samples are NOT suitable. If pulmonary infiltrates are present then a BAL sample is required.
  • The reference laboratory supplies the MIcrobiology Department with a strictly limited number of Mycobacterial blood culture bottles, so testing is restricted to the conditions listed above following discussion with the duty Consultant Microbiologist
  • The reference laboratory cannot accept samples at weekends, so we must forward bottles during the normal working week only. Therefore, samples should only be collected Monday to Thursday and must be received in the laboratory before 5.00pm on the same day. If taken in Cheltenham, please allow time for transport to Gloucester.
  • Do not remove, cover or in any way deface the bottle barcode
  • If using addressograph labels do not cover the bottle barcode
  • See also: Mycobacterium investigations

BACTEC Myco bottle and fill

Sample requirements

Mycobacterial blood culture bottle (BD BACTEC myco/F Lytic)

Needle and syringe or direct draw adaptor and butterfly line

1–5 mL blood (3–5 mL is optimal)

Collection method

  • Remove the flip-off cap from the bottle and inspect for cracks, leaks, contamination, excessive cloudiness and bulging or indented septum. DO NOT USE if any defect is noted.
  • Before inoculating, disinfect the septum with an alcohol wipe. Allow the septum to air dry.
  • Collect blood sample aseptically and inoculate 1–5 mL (3–5 mL is optimal) into the bottle. Collect this sample first before filling any other blood tubes or bottles.
  • Refer to Trustwide Clinical Policy A0296: Blood Culture Sampling for comprehensive sampling instructions.
  • Transport to the Microbiology Laboratory at GRH without delay.
  • The bottle is made of glass and must not be transported in the air tube system.

Required information

  • Relevant clinical details

Storage/transport

  • Send to the laboratory as soon as possible. Transport samples at room temperature.
  • DO NOT USE the air tube

Turnaround time

  • Sent to a National Reference Centre
  • Up to 6 weeks for culture
  • Identification, sensitivity testing and typing results may take considerably longer

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