Blood Culture Contamination and Subsequent Unnecessary Health Care Utilization in Pediatrics

Area of Science:

• Clinical Microbiology
• Health Economics
• Pediatric Infectious Diseases

Background:

• Contaminated blood cultures incur substantial healthcare costs in the US, primarily due to increased utilization and antibiotic exposure.
• The economic and clinical burden of contaminated blood cultures in pediatric populations remains under-described.

Purpose of the Study:

• To quantify the healthcare utilization and associated costs of contaminated blood cultures in pediatric patients.
• To compare outcomes between pediatric patients with contaminated blood cultures and those with true positive or negative results.

Main Methods:

• A retrospective cohort study analyzed 128,524 blood cultures from 2010-2022 across multicenter outpatient and hospital settings.
• Cultures with commensal organisms were classified as contaminated, excluding high-risk pediatric patients.
• Healthcare utilization, costs, antibiotic use, and blood draw frequency were compared between contaminated and non-contaminated culture groups.

Main Results:

• Contaminated blood cultures significantly increased the odds of emergency department visits (15-fold) and admissions (6-fold).
• Patients with contaminated cultures experienced a 32% longer length of stay, with associated costs of approximately $980 per outpatient contaminant and $2500 per inpatient contaminant.
• Contaminated cultures led to increased antibiotic administration and more frequent blood draws compared to non-contaminated cultures.

Conclusions:

• Pediatric blood culture contamination results in significant excess healthcare utilization and substantial economic costs.
• These findings underscore the need for strategies to minimize blood culture contamination in pediatric care to reduce costs and improve patient management.