SHM Converge Scientific Abstract ePoster Gallery-Variation in Blood Culture Testing and Outcomes in Children Hospitalized With Three Common Infections

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This study examined blood culture (BC) testing in children hospitalized with three common, uncomplicated infections: community-acquired pneumonia (CAP), skin and soft tissue infection (SSTI), and urinary tract infection (UTI). Using the PHIS database, researchers analyzed 94,524 hospitalizations across 31 hospitals from 2016 to 2023, excluding children with complicated illness, ICU admission, major medical complexity, or long stays.<br /><br />BC testing was common: cultures were obtained in 41% of CAP cases, 45% of SSTI cases, and 55% of UTI cases. Testing varied substantially between hospitals. Based on k-means clustering, hospitals were grouped into low, moderate, and high BC testing categories. Trends over time also differed: 7 hospitals increased testing, 17 had stable rates, and 7 decreased testing.<br /><br />The study found little evidence that higher BC testing improved outcomes. After adjustment, there were no significant differences between high- and low-testing hospitals in length of stay, costs, emergency department revisits, or hospital readmissions, except for lower 3-day readmissions in the high-testing group.<br /><br />Overall, the findings suggest that routine BC testing remains frequent despite prior evidence showing low clinical utility in these uncomplicated infections. The authors conclude that BC use is still highly variable and often persists without clear benefit, highlighting an opportunity to safely reduce unnecessary testing, especially given current concerns about resource use and blood culture shortages.

Asset Subtitle

John R. Stephens

Meta Tag

Author List Andrew Yu, Irma Ugalde, Jennifer Goldman, Jessica L. Markham, Jillian M. Cotter, John R. Stephens, Matt Hall, Matthew J. Molloy, Michael J. Steiner, Michelle Polich, Ronald J. Teufel II, Samantha A. House, Smit Shah

Category Research

Concept Blood Culture Testing

Concept Hospital Variation

Concept Pediatric Hospitalization

Concept Community-Acquired Pneumonia

Concept Skin and Soft Tissue Infection

Distinguished Non-Finalist

Presenter Organization University of North Carolina

Presenting Author John R. Stephens

Track Pediatric

Keywords

blood culture testing

pediatric hospitalization

community-acquired pneumonia

skin and soft tissue infection

urinary tract infection

PHIS database

hospital variation

k-means clustering

resource utilization

unnecessary testing

Blood Culture Testing

Hospital Variation

Pediatric Hospitalization

Community-Acquired Pneumonia

Skin and Soft Tissue Infection