Related Experiment Video
Updated: Jun 24, 2026
Preparation of a Blood Culture Pellet for Rapid Bacterial Identification and Antibiotic Susceptibility Testing
Published on: October 15, 2014
Utility of blood cultures in postoperative pediatric intensive care unit patients
Andrew W Kiragu1, Judith Zier, David N Cornfield
1Department of Pediatrics, Center for Excellence in Pulmonary Biology, Stanford University, Stanford, CA, USA.
Insights
Fever in the first 48 hours after pediatric intensive care unit (PICU) admission is rarely bacteremia. Blood cultures in these low-risk patients are unlikely to be positive, suggesting the practice may not be justified.
Area of Science:
- Pediatric Intensive Care
- Infectious Disease Diagnostics
- Healthcare Economics
Background:
- Fever is a common postoperative complication in pediatric intensive care units (PICUs).
- The utility of blood cultures in febrile pediatric patients within 48 hours postoperatively requires evaluation.
- Identifying bacteremia early is crucial for appropriate antibiotic management.
Purpose of the Study:
- To determine the incidence of positive blood cultures in febrile pediatric patients within 48 hours of surgery.
- To assess the clinical utility and cost-effectiveness of routine blood cultures in this specific patient group.
- To inform clinical practice guidelines regarding fever workup in postoperative PICU patients.
Main Methods:
- Retrospective chart review of 602 postoperative patients admitted to a PICU over 18 months.
- Inclusion criteria: temperature >100.4°F and blood cultures drawn within 48 hours postoperatively.
- Exclusion criteria: non-first surgery, discharge <48 hours, or central venous catheter >24 hours pre-admission.
Main Results:
- Sixty-six patients were febrile and had blood cultures drawn (111 total cultures).
- Only one blood culture (0.9%) was positive for bacteremia.
- The estimated cost per positive blood culture was $23,532.
Conclusions:
- Fever within 48 hours postoperatively in low-risk pediatric patients is unlikely to indicate bacteremia.
- Routine blood cultures in this population yield low positive rates.
- Discontinuing routine blood cultures may improve care focus and reduce healthcare costs.
Objective:
To determine the frequency of positive blood cultures in patients with fevers in the initial 48-hour postoperative period.
Study Design:
All patients who had blood cultures drawn during the initial 48 hours postoperatively while in the pediatric intensive care unit (PICU) at the University of Minnesota Children's Hospital-Fairview during an 18-month period were included in the current study. Six hundred two postoperative patients were admitted to the PICU during the study period. Patients with a temperature >100.4 degrees F and who had blood cultures drawn were identified. Patients for whom the operative procedure was not the first in that admission, those discharged in <48 hours, and those with an indwelling central venous catheter for >24 hours before their admission were excluded.
Results:
Sixty-six of these patients were febrile and had blood cultures drawn in the initial 48 hours postoperatively. One hundred eleven blood cultures were obtained. A single (0.9%) blood culture was positive. The cost per positive culture was estimated at $23,532.
Conclusions:
Even in patients admitted to the PICU, fever in the initial 48-hour postoperative period is unlikely to represent bacteremia in low-risk pediatric patients. Blood cultures in these patients are, therefore, unlikely to yield positive results. Procurement of blood cultures in this patient population is not justified. Cessation of the practice of blood culture procurement in this patient population may both focus care and provide enable meaningful cost savings.
Related Concept Videos
01:26Urine Studies II: Urine Culture and Sensitivity Test
01:24Automated Microbial Diagnostics
01:20Sputum Studies II: Culture and Sensitivity
Sputum culture and sensitivity is a medical procedure used to diagnose bacterial infections in the respiratory tract and select the most appropriate antibiotics for treatment. This process involves analyzing sputum samples of thick and opaque secretions produced in the lungs and airways. These samples are collected from patients and then sent to the laboratory for analysis.
The test can identify various pathogens responsible for respiratory infections, including Streptococcus,...
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:26Blood Studies I: ABG and VBG
Arterial Blood Gas (ABG)
Arterial Blood Gas (ABG) studies are crucial for assessing the lungs' ability to supply oxygen and remove carbon dioxide, reflecting the patient's ventilation status. They also help understand the kidneys' capacity to reabsorb or...
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention