{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:01:52Z","timestamp":1790812912041,"version":"4.1.0"},"reference-count":15,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Although contaminated blood cultures are known to result in billions of dollars in annual health care costs in the United States due to excess health care utilization and antibiotic exposure, the burden in pediatrics is not well described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Retrospective cohort study of 128\u2009524 blood cultures obtained from 2010 to 2022 in outpatient and hospital settings in a multicenter health care system. Cultures with commensal organisms were considered contaminated after excluding patients with high-risk conditions, including immunodeficiencies, malignancy, and indwelling catheters. Health care utilization and cost assessment were analyzed and compared between patients with contaminated blood cultures and patients with true positive or negative blood cultures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Contaminated blood cultures resulted in 15-fold (odds ratio [OR]\u2009=\u200915.10; 95% CI: 13.50\u201317.00) higher odds of emergency department (ED) visits, 6-fold (OR\u2009=\u20095.71; 95% CI: 4.63\u20137.05) higher odds of admissions, and 32% longer length of stay (risk ratio\u2009=\u20091.32; 95% CI: 1.26\u20131.39) compared with age-matched noncontaminated negative blood cultures. This resulted in approximately $980 in ED costs per contaminant for outpatients and $2500 in hospital costs per contaminant for inpatients, a total of $1.5 million in ED costs over the study. Patients with contaminated cultures received more antibiotics and underwent more blood draws than patients with negative blood cultures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Pediatric blood culture contamination results in excess reutilization with significant economic costs and impact on patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/hpeds.2025-008960","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:02:46Z","timestamp":1773360166000},"page":"331-338","source":"Crossref","is-referenced-by-count":1,"title":["Blood Culture Contamination and Subsequent Unnecessary Health Care Utilization in Pediatrics"],"prefix":"10.1542","volume":"16","author":[{"given":"Kelsey","family":"Childress","sequence":"first","affiliation":[{"name":"1Division of Hospital Pediatrics, Kaiser Permanente Northern California, Roseville, California"},{"name":"2The Permanente Medical Group, Oakland, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hartmann","sequence":"additional","affiliation":[{"name":"3Division of Research, Kaiser Permanente Northern California, Pleasanton, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilyn L.","family":"Kwan","sequence":"additional","affiliation":[{"name":"3Division of Research, Kaiser Permanente Northern California, Pleasanton, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Cooch","sequence":"additional","affiliation":[{"name":"1Division of Hospital Pediatrics, Kaiser Permanente Northern California, Roseville, California"},{"name":"4Division of Infectious Diseases, Pediatrics, Kaiser Permanente Northern California, Oakland, California."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"issue":"1","key":"2026033119571452000_r1","doi-asserted-by":"crossref","first-page":"e00009","DOI":"10.1128\/CMR.00009-19","article-title":"Practical guidance for clinical microbiology laboratories: a comprehensive update on the problem of blood culture contamination and a discussion of methods for addressing the problem","volume":"33","author":"Doern","year":"2019","journal-title":"Clin Microbiol Rev."},{"issue":"4","key":"2026033119571452000_r2","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/j.jhin.2019.03.012","article-title":"Model to evaluate the impact of hospital-based interventions targeting false-positive blood cultures on economic and clinical outcomes","volume":"102","author":"Geisler","year":"2019","journal-title":"J Hosp Infect."},{"issue":"4","key":"2026033119571452000_r3","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1128\/JCM.02162-08","article-title":"Impact of blood cultures drawn by phlebotomy on contamination rates and health care costs in a hospital emergency department","volume":"47","author":"Gander","year":"2009","journal-title":"J Clin Microbiol."},{"issue":"2","key":"2026033119571452000_r4","doi-asserted-by":"crossref","first-page":"e492","DOI":"10.1542\/peds.2015-1296","article-title":"Tip of the iceberg: understanding the unintended consequences of antibiotics","volume":"136","author":"Goldman","year":"2015","journal-title":"Pediatrics."},{"issue":"8","key":"2026033119571452000_r5","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1086\/677161","article-title":"Cost analysis of strategies to reduce blood culture contamination in the emergency department: sterile collection kits and phlebotomy teams","volume":"35","author":"Self","year":"2014","journal-title":"Infect Control Hosp Epidemiol."},{"key":"2026033119571452000_r6","article-title":"Emergency department visits exceed affordability threshold for many consumers with private insurance 2022","author":"Schwartz"},{"key":"2026033119571452000_r7","article-title":"Health Facts: Hospital Adjusted Expenses per Inpatient Day","author":"KFF"},{"key":"2026033119571452000_r8","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen","year":"1988","edition":"2nd ed"},{"issue":"7","key":"2026033119571452000_r9","doi-asserted-by":"crossref","first-page":"e286","DOI":"10.1542\/hpeds.2024-008184","article-title":"Pediatric blood culture contamination rates and risk factors in a large integrated health system","volume":"15","author":"Childress","year":"2025","journal-title":"Hosp Pediatr."},{"issue":"2","key":"2026033119571452000_r10","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1093\/jpids\/piy125","article-title":"Reporting and categorization of blood culture contaminants in infants and young children: a scoping review","volume":"9","author":"Chappell-Campbell","year":"2020","journal-title":"J Pediatric Infect Dis Soc."},{"issue":"3","key":"2026033119571452000_r11","doi-asserted-by":"crossref","first-page":"e0100521","DOI":"10.1128\/jcm.01005-21","article-title":"Blood culture utilization in the hospital setting: a call for diagnostic stewardship","volume":"60","author":"Fabre","year":"2022","journal-title":"J Clin Microbiol."},{"issue":"5","key":"2026033119571452000_r12","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1002\/jhm.2541","article-title":"Culture if spikes? Indications and yield of blood cultures in hospitalized medical patients","volume":"11","author":"Linsenmeyer","year":"2016","journal-title":"J Hosp Med."},{"issue":"5","key":"2026033119571452000_r13","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1542\/hpeds.2020-000976","article-title":"Management of pediatric nonpathogenic blood cultures after introduction of PCR technology","volume":"11","author":"Hughes","year":"2021","journal-title":"Hosp Pediatr."},{"issue":"10","key":"2026033119571452000_r14","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1017\/ice.2022.314","article-title":"Clinical outcomes associated with blood-culture contamination are not affected by utilization of a rapid blood-culture identification system","volume":"44","author":"Khan","year":"2023","journal-title":"Infect Control Hosp Epidemiol."},{"issue":"3","key":"2026033119571452000_r15","first-page":"267","article-title":"Clinical impact and provider acceptability of real-time antimicrobial stewardship decision support for rapid diagnostics in children with positive blood culture results","volume":"6","author":"Messacar","year":"2017","journal-title":"J Pediatric Infect Dis Soc."}],"container-title":["Hospital Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article-pdf\/16\/4\/331\/1916933\/hosppeds.2025008960.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article-pdf\/16\/4\/331\/1916933\/hosppeds.2025008960.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T23:57:20Z","timestamp":1775001440000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article\/16\/4\/331\/206782\/Blood-Culture-Contamination-and-Subsequent"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,13]]},"references-count":15,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,3,13]]},"published-print":{"date-parts":[[2026,4,1]]}},"URL":"https:\/\/doi.org\/10.1542\/hpeds.2025-008960","relation":{},"ISSN":["2154-1663","2154-1671"],"issn-type":[{"value":"2154-1663","type":"print"},{"value":"2154-1671","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,13]]}}}