1391 How Useful are Blood Cultures on PICU?

Abstract

Objectives: To determine the current practice of obtaining blood cultures sent from PICU. Methods: Retrospective study of all blood cultures sent from patients in one calendar month (January 2009). Results: A total of 140 blood cultures were sent from 34 patients over 89 screening episodes. Only 22% of screening episodes achieved the minimum requirement of cultures of blood, urine and ET aspirates. Neither clinical parameters nor infective indices showed reliable correlation with positive blood cultures. 23 (16%) of blood cultures were positive whilst 9 samples were attributed to probable contaminants. A single patient (with Candidaemia) accounted for 10 positive samples. Blood cultures were obtained from different sites including peripheral (36), arterial (54), central (50). The number of positive cultures were equivalent from each of these sites. Of the patients screened after admission 60 were already receiving IV antibiotics. Conclusions: Blood cultures were commonly performed and demonstrated a low overall yield perhaps as a result of the criteria used for screening. Several areas of practice warrant improvement including obtaining a complete screen more often and implementing measures to reduce the contamination of peripheral samples (no touch technique).A prospective study would be needed to determine the criteria for screening more accurately. Furthermore, there is a need for more reliable indices of infection which may also reduce the use of antimicrobials.