Name of the Procedure:

Blood Culture for Infectious Disease (Bacterial and Fungal), Organism Identification, using rRNA Fluorescent In Situ Hybridization (FISH), with 6 or More Targets and Antimicrobial Susceptibility Based on Minimum Inhibitory Concentration (MIC) Testing

Summary

This procedure involves taking a blood sample to identify bacterial and fungal infections using a technique called rRNA Fluorescent In Situ Hybridization (FISH). The test targets six or more different microorganisms to determine if they are present. It also involves testing the microorganisms to see which antibiotics are effective against them.

Purpose

This procedure is used to diagnose infections in the blood caused by bacteria or fungi. The goal is to accurately identify the specific organisms causing the infection and determine the most effective antibiotics for treatment.

Indications

• Unexplained fever or chills
• Suspected sepsis or bloodstream infection
• Persistent or recurrent infections
• Immune-compromised patients with symptoms of infection
• Patients with implanted medical devices showing signs of infection

Preparation

• The patient may need to fast for a few hours before the blood draw.
• Patients should inform their healthcare provider about any medications they are taking, as certain medications may need to be paused.
• No specific diagnostic tests are required beforehand.

Procedure Description

1. The healthcare provider cleans the area of the skin where the blood sample will be taken.
2. A blood sample is drawn from a vein in the arm using a sterile needle.
3. The sample is then sent to a laboratory where it undergoes rRNA FISH testing to identify bacteria or fungi.
4. If organisms are detected, phenotypic minimum inhibitory concentration (MIC) testing is performed to determine which antibiotics the microorganisms are susceptible to.

Duration

The blood draw itself takes about 5 to 10 minutes. Laboratory analysis can take 24 to 48 hours.

Setting

The blood draw can be performed in a hospital, outpatient clinic, or a doctor’s office. Laboratory analysis is conducted in a specialized medical laboratory.

Personnel

• Phlebotomists or nurses to draw blood
• Medical laboratory technicians or technologists
• Microbiologists and infectious disease specialists

Risks and Complications

• Common: Mild pain, bruising, or bleeding at the site of the blood draw
• Rare: Infection at the puncture site, fainting, or dizziness

Benefits

• Accurate identification of the causative organism(s)
• Determination of the most effective antibiotic treatment
• Quick results compared to traditional culture methods, facilitating timely treatment

Recovery

• Patients can resume normal activities immediately after the blood draw.
• In the case of treatment with antibiotics, follow-up appointments may be needed to monitor response to therapy.

Alternatives

• Traditional blood cultures, taking longer to yield results and potentially less sensitive
• Broad-spectrum antibiotic treatment without specific organism identification, which can be less effective and lead to antibiotic resistance

Patient Experience

• Patients may experience a brief pinch or sting during the blood draw and slight discomfort or bruising afterward.
• Most discomfort is minimal and subsides quickly.
• Pain management is typically unnecessary, but over-the-counter pain relievers can be taken if needed.