{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T07:07:51Z","timestamp":1789110471052,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["1K08HS029693\u201001A1"],"award-info":[{"award-number":["1K08HS029693\u201001A1"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Routine blood culture (BCx) testing in uncomplicated community\u2010acquired pneumonia (CAP), skin and soft tissue infections (SSTI), and urinary tract infections (UTI) has demonstrated low clinical utility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate hospital\u2010level BCx testing trends and their association with clinical outcomes for children hospitalized with CAP, SSTI, and UTI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study used the Pediatric Health Information System database to identify hospitalizations of children aged 3 months\u201318 years with CAP, SSTI, and UTI from 2016 to 2024. We excluded patients with complicated infections, complex chronic conditions, intensive care unit admission, or length of stay (LOS)\u2009&gt;\u20097 days. Hospital\u2010level BCx testing rates were calculated by infection type, and annual trends were examined. Hospitals were grouped into low, moderate, and high BCx testing groups. Outcomes including LOS, costs, readmissions, and emergency department revisits were compared across hospital groups, adjusting for infection type, age, and illness severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 133,783 encounters across 37 hospitals, BCxs were obtained in 42% hospitalizations for CAP, 46% for SSTI, and 56% for UTI hospitalizations with substantial hospital\u2010level variation (e.g., 14%\u201377% for CAP). Over time, four hospitals showed significant increases, eight showed decreases, and 25 showed no change in annual BCx testing. No clinically significant differences in outcomes were observed across low (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915), moderate (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200914), or high (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098) hospital testing groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BCx testing remains frequent for CAP, SSTI, and UTI with a minority of hospitals demonstrating testing reductions over time. The frequency of BCx testing and lack of significant differences in outcomes suggests opportunities for diagnostic stewardship.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jhm.70470","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T06:40:13Z","timestamp":1789108813000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Variation in blood culture testing in children hospitalized with three common infections"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9565-8731","authenticated-orcid":false,"given":"Smit","family":"Shah","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Hospital Medicine, Children's Mercy Kansas City University of Missouri\u2010Kansas City School of Medicine Kansas City Missouri USA"},{"name":"University of Kansas School of Medicine Kansas City Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Goldman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Hospital Medicine, Children's Mercy Kansas City University of Missouri\u2010Kansas City School of Medicine Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7778-5887","authenticated-orcid":false,"given":"Matt","family":"Hall","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Hospital Medicine, Children's Mercy Kansas City University of Missouri\u2010Kansas City School of Medicine Kansas City Missouri USA"},{"name":"Children's Hospital Association Lenexa Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R.","family":"Stephens","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of North Carolina at Chapel Hill Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jillian M.","family":"Cotter","sequence":"additional","affiliation":[{"name":"Section of Hospital Medicine Children's Hospital Colorado Aurora Colorado USA"},{"name":"Department of Pediatrics University of Colorado Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha A.","family":"House","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Dartmouth Health Children's Lebanon New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6290-568X","authenticated-orcid":false,"given":"Matthew J.","family":"Molloy","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Polich","sequence":"additional","affiliation":[{"name":"Rady Children's Hospital, San Diego, California University of California San Diego San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Steiner","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Oklahoma College of Medicine Tulsa Oklahoma USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9710-8920","authenticated-orcid":false,"given":"Michael J.","family":"Tchou","sequence":"additional","affiliation":[{"name":"Section of Hospital Medicine Children's Hospital Colorado Aurora Colorado USA"},{"name":"Department of Pediatrics University of Colorado Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"II","given":"Ronald J.","family":"Teufel","sequence":"additional","affiliation":[{"name":"Rady Children's Hospital, San Diego, California University of California San Diego San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8899-4040","authenticated-orcid":false,"given":"Irma T.","family":"Ugalde","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The University of Chicago Pritzker School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9878-5376","authenticated-orcid":false,"given":"Andrew G.","family":"Yu","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, Department of Pediatrics University of Texas Southwestern Medical Center Dallas Texas USA"},{"name":"Children's Medical Center, Dallas, Texas, 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