ArticlePediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2020
Practices, Perceptions, and Attitudes in the Evaluation of Critically Ill Children for Bacteremia: A National Survey.
Article in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 24 citations in OpenAlex.
- Blood Culture Practices in Pediatric Intensive Care Units to Inform a Diagnostic Stewardship Intervention.Hospital pediatrics · 2026Article
- Antimicrobial Stewardship Programs in Pediatric Intensive Care Units: A Systematic Scoping Review.Antibiotics (Basel, Switzerland) · 2025Review
- Antibiotic Exposure of Critically Ill Children at a Tertiary Care Paediatric Intensive Care Unit in Switzerland.Children (Basel, Switzerland) · 2024Article
- Mixed-methods process evaluation of a respiratory-culture diagnostic stewardship intervention.Infection control and hospital epidemiology · 2023Article
- Numbers and narratives: how qualitative methods can strengthen the science of paediatric antimicrobial stewardship.JAC-antimicrobial resistance · 2022Review
- Diagnostic Stewardship in the Pediatric Intensive Care Unit.Infectious disease clinics of North America · 2022Review
- Effect of Early Nutritional Assessment and Nutritional Support on Immune Function and Clinical Prognosis of Critically Ill Children.Journal of healthcare engineering · 2022Article
- Evidence-based Evaluation to Promote High-value Care in Pediatric Critical Care: It Is Time to Fully Adopt.Pediatric quality & safetyArticle
- Culture Ordering for Patients with New-onset Fever: A Survey of Pediatric Intensive Care Unit Clinician Practices.Pediatric quality & safetyArticle
- Determinants of Blood Culture Use in Critically Ill Children: A Multicenter Qualitative Study.Pediatric quality & safetyArticle
- Survey-based Work System Assessment to Facilitate Large-scale Dissemination of Healthcare Quality Improvement Programs.Pediatric quality & safetyArticle
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Authors and funding
11 authors at 5 institutions in 1 country.
Funding
Abstract
objectivesSending blood cultures in children at low risk of bacteremia can contribute to a cascade of unnecessary antibiotic exposure, adverse effects, and increased costs. We aimed to describe practice variation, clinician beliefs, and attitudes about blood culture testing in critically ill children.
designCross-sectional electronic survey.
settingFifteen PICUs enrolled in the Blood Culture Improvement Guidelines and Diagnostic Stewardship for Antibiotic Reduction in Critically Ill Children collaborative, an investigation of blood culture use in critically ill children in the United States. SUBJECTS: PICU clinicians (bedside nurses, resident physicians, fellow physicians, nurse practitioners, physician assistants, and attending physicians).
interventionsNone. MEASUREMENT AND MAIN
resultsSurvey items explored typical blood culture practices, attitudes and beliefs about cultures, and potential barriers to changing culture use in a PICU setting. Fifteen of 15 sites participated, with 347 total responses, 15-45 responses per site, and an overall median response rate of 57%. We summarized median proportions and interquartile ranges of respondents who reported certain practices or beliefs: 86% (73-91%) report that cultures are ordered reflexively; 71% (61-77%) do not examine patients before ordering cultures; 90% (86-94%) obtain cultures for any new fever in PICU patients; 33% (19-61%) do not obtain peripheral cultures when an indwelling catheter is in place; and 64% (36-81%) sample multiple (vs single) lumens of central venous catheters for new fever. When asked about barriers to reducing unnecessary cultures, 80% (73-90%) noted fear of missing sepsis. Certain practices (culture source and indication) varied by clinician type. Obtaining surveillance cultures and routinely culturing all possible sources (each lumen of indwelling catheters and peripheral specimens) are positively correlated with baseline blood culture rates.
conclusionsThere is variation in blood culture practices in the PICU. Fear and reflexive habits are common drivers of cultures. These practices may contribute to over-testing for bacteremia. Further investigation of how to optimize blood culture use is warranted.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.