Characteristics Associated With Positive Bacterial Blood Cultures in Pediatrics

Area of Science:

• Pediatric Infectious Diseases
• Clinical Microbiology
• Antibiotic Stewardship

Background:

• Empiric antibiotic use is common pending bacterial bloodstream infection (BSI) results.
• Identifying BSI predictors and culture time-to-positivity (TTP) can optimize diagnostics and antibiotic use.

Purpose of the Study:

• To analyze clinical characteristics associated with true BSIs versus contaminants.
• To identify factors influencing BSI time-to-positivity (TTP).

Main Methods:

• Retrospective review of positive bacterial blood cultures in a pediatric healthcare system (March 2021-June 2022).
• Classification of cultures as BSIs or contaminants based on clinical management.
• Analysis of demographics, clinical data, and culture TTP.

Main Results:

• 71% of 1068 positive cultures were treated as BSIs.
• BSIs were associated with age <90 days, fever/hypothermia, hypotension, central lines, or neutropenia.
• Prolonged TTP (>24 hours) linked to peripheral draws, single positive cultures, and absence of fever.

Conclusions:

• Defined clinical characteristics for pediatric BSIs.
• Most BSIs are identified within 36 hours.
• Data can inform blood culture collection guidelines for BSI evaluation.