Comparison of macroscopic examination, routine gram stains, and routine subcultures in the initial detection of positive blood cultures.

Blood was cultured in two vaccum bottles containing Columbia broth with sodium polyanethol sulfonate and CO(2). Filtered air was admitted to one bottle, and the bottles were incubated at 35 C until growth was detected or for a maximum of 7 days. Bottles were examined daily for macroscopic growth. Gram stains were made routinely on the 1st, 4th, and 7th days, and samples were routinely subcultured to sheep blood agar (incubated in GasPak jar) and chocolate agar (incubated in CO(2)) on the 1st and 4th days of incubation. Of 1,127 positive blood cultures, 65% were first detected by macroscopic examination, 23% were first detected by Gram stain, and 12% were first detected only by subculture.