Related Experiment Video
Updated: Aug 11, 2026
Preparation of a Blood Culture Pellet for Rapid Bacterial Identification and Antibiotic Susceptibility Testing
Published on: October 15, 2014
Resource utilization and contaminated blood cultures in children at risk for occult bacteremia
1Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287-3144, USA. gsegal@jhmi.edu
Insights
Contaminated blood cultures in children at risk for occult bacteremia significantly increase healthcare costs and resource use. Addressing these false positives is crucial for effective patient management and cost-efficiency in pediatric emergency care.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Microbiology
- Health Services Research
Background:
- Occult bacteremia evaluation in children presents diagnostic challenges.
- Contaminated blood cultures are a common issue in pediatric emergency departments.
- The economic impact of false-positive blood cultures is not fully understood.
Purpose of the Study:
- To quantify resource utilization and hospital charges linked to evaluating contaminated blood cultures in at-risk pediatric patients.
- To assess the financial burden of false-positive results in blood culture diagnostics.
Main Methods:
- Retrospective medical record review of children aged 3 to 36 months with positive blood cultures.
- Analysis of follow-up actions including telephone calls, return visits, additional tests, and hospital admissions.
- Tabulation of associated hospital charges for services rendered due to contaminated cultures.
Main Results:
- Of 491 positive blood cultures, 85 (41%) were contaminants in patients at risk for occult bacteremia.
- Follow-up for these 85 patients incurred 106 calls, 49 return ED visits, 102 tests, and 12 admissions (24 days).
- This resulted in $78,904 in additional charges, averaging $642 per contaminated culture.
Conclusions:
- Contaminated blood cultures in children at risk for occult bacteremia significantly increase healthcare resource utilization and costs.
- These findings highlight the need to incorporate the impact of false-positive results into clinical decision-making and cost-effectiveness analyses.
- Strategies to reduce blood culture contamination are essential for optimizing pediatric emergency care.
Objective:
To measure the increases in resource utilization and hospital charges associated with the evaluation of contaminated blood cultures obtained from emergency department patients at risk for occult bacteremia.
Design:
Retrospective medical record review.
Setting:
Emergency department of an urban, university-affiliated pediatric referral center.
Patients:
Children aged 3 to 36 months with blood cultures positive for bacterial growth obtained between January 1994 and October 1996.
Main Outcome Measures:
Increased resource utilization related to contaminated blood culture follow-up, including telephone contact, return emergency department visits, additional diagnostic tests and therapies performed at reevaluation, and hospital admissions. Hospital charges for these additional services were tabulated.
Results:
Of 8,306 children who had blood cultures drawn, 491 (5.9%) had positive findings. Four hundred eighty-five (98.8%) of these were available for review. Two hundred seventy-six (57%) of 485 were excluded from final analysis. Of the remaining 209 patients at risk for occult bacteremia, 85 (41%) had cultures that grew contaminants only. Follow-up of these 85 patients generated 106 telephone calls, 49 return visits to the emergency department, 102 additional diagnostic tests, 18 doses of parenteral antibiotics, and 12 hospital admissions with a combined length of stay of 24 days. This resulted in additional charges of $78,904, or an additional $642 per true pathogen recovered.
Conclusions:
Contaminated blood cultures obtained from children at risk for occult bacteremia lead to substantial increases in resource utilization and hospital charges. These untoward effects should be accounted for in formal decision analyses regarding the management of occult bacteremia.
More Related Videos
Related Concept Videos
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:26Urine Studies II: Urine Culture and Sensitivity Test