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Description

Background: Routine blood culture (BC) testing in uncomplicated community-acquired pneumonia (CAP), skin and soft tissue infections (SSTI), and urinary tract infections (UTI) has demonstrated low clinical utility. Objectives: To evaluate hospital-level BC testing trends and their association with clinical outcome differences for children hospitalized with CAP, SSTI, and UTI. Methods: This retrospective cohort study used the Pediatric Health Information System database to identify hospitalizations of children aged 3 months-18 years admitted with CAP, SSTI, or UTI from 2016-2023. We excluded patients with complicated infections, medical complexity, ICU admission, or length of stay (LOS) >7 days. Hospital-level BC testing rates were calculated by infection type, and trends examined annually. Hospitals were grouped into low, moderate, and high BC testing groups. Clinical and financial outcomes were compared across groups, adjusting for infection type, age, and illness severity. Results: Among 94,524 hospitalizations at 31 hospitals, BCs were obtained in 41% of CAP, 45% of SSTI, and 55% of UTI cases, with significant hospital-level variation. Seven hospitals showed significant increases, seven showed decreases, and 17 showed no change in annual BC testing. Clustering grouped hospitals as low (n = 13), moderate (n = 10), and high (n = 8) testers. No clinically significant differences in clinical or financial outcomes were observed across testing groups. Conclusions: BC testing rates remain high and vary widely among hospitals for three common pediatric infections. Despite growing evidence against routine testing, many hospitals have not reduced BC use.

Publication Date

4-2025

Disciplines

Infectious Disease | Pediatrics

When and Where Presented

Presented at the 2025 Pediatric Academic Societies (PAS) Annual Meeting; Honolulu, HI; April 24-28, 2025.

Variation in Blood Culture Testing for Three Common Infections

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