Situation and questions regarding the practice of blood cultures in paediatric patients: an opinion paper.

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Bibliographic Details
Title:	Situation and questions regarding the practice of blood cultures in paediatric patients: an opinion paper.
Alternate Title:	Situación y cuestiones relacionadas con la realización de hemocultivos en pacientes pediátricos: un documento de opinión.
Authors:	Burillo, Almudena^1,2,3 almudena.burillo@gmail.com, Estévez, Agustín^1,2,3, Kestler, Martha^1,2,3, Pérez-Granda, María Jesús^1,2,3,4,5, Muñoz, Patricia^1,2,3,4, Bouza, Emilio^1,2,3,4
Source:	Revista Española de Quimioterapia. jun2026, Vol. 39 Issue 3, p172-190. 19p.
Subjects:	MICROBIAL cultures, BACTEREMIA, INFECTION prevention, NEWBORN infants, DIAGNOSIS, SEPSIS, MEDICAL protocols, CHILD patients
Abstract (English):	The collection and interpretation of blood cultures in paediatric patients require specific considerations that make simple extrapolation from adult recommendations inappropriate. In recent years, the incidence and aetiology of paediatric bacteraemia have evolved, influenced by vaccination programmes, improved infection prevention strategies, and increasing clinical complexity, particularly in neonatal, oncohaematological, and intensive care settings. Clinical guidelines recommend blood cultures in neonates and infants with fever without a focus in children with sepsis or shock, with immunosuppression, suspected endovascular infection, meningitis, osteoarticular infections, or severe community-acquired pneumonia. Conversely, routine use is discouraged in clearly viral infections and in mild cases in previously healthy children. Available evidence consistently identifies the volume of blood inoculated as the main determinant of diagnostic performance, and this should be adjusted for age and weight. Obtaining one or two appropriately indicated peripheral blood culture sets, together with proper antisepsis, reduces contamination and improves clinical interpretation. Whenever feasible, both aerobic and anaerobic bottles should be included, given their complementary diagnostic yield. There is no robust evidence that paediatric bottles with smaller broth volumes provide substantial advantages over standard bottles when adequate blood volumes are inoculated. Importantly, no evidence demonstrates that the type of bottle or automated system used influences hospital stay, clinical outcomes, or mortality. This article presents an evidence-informed perspective that integrates current literature with expert clinical judgment, derived from more than four decades of experience at a high-complexity tertiary-care hospital. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	La práctica de los hemocultivos en pediatría requiere un enfoque específico y no debe extrapolarse automáticamente de la población adulta. La epidemiología de la bacteriemia pediátrica ha experimentado cambios relevantes en las últimas décadas, condicionados por los programas de vacunación, la mejora de las medidas de prevención de la infección nosocomial y la mayor complejidad de los pacientes, especialmente en áreas neonatales, oncohematológicas y de cuidados intensivos. Las principales guías coinciden en indicar hemocultivos en neonatos y lactantes con fiebre sin foco, en situaciones de sepsis o shock, de inmunosupresión, de sospecha de infección endovascular, de meningitis, de infecciones osteoarticulares y de neumonía comunitaria grave. Por el contrario, no se recomienda su uso sistemático en infecciones claramente virales ni en cuadros leves en niños previamente sanos. El volumen de sangre inoculado es el factor que más influye en el rendimiento diagnóstico y debe ajustarse al peso y a la edad del paciente. La obtención de una o dos extracciones por venopunción periférica, junto con una antisepsia rigurosa, disminuye la contaminación y mejora la interpretación clínica. Siempre que sea posible, deben emplearse botellas aerobias y anaerobias por su carácter complementario. La evidencia disponible no demuestra ventajas sustanciales de las botellas pediátricas frente a las estándar cuando se inoculan volúmenes adecuados, ni que el tipo de sistema automatizado modifique la estancia hospitalaria, el consumo antibiótico o la mortalidad. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

Description
Abstract:	The collection and interpretation of blood cultures in paediatric patients require specific considerations that make simple extrapolation from adult recommendations inappropriate. In recent years, the incidence and aetiology of paediatric bacteraemia have evolved, influenced by vaccination programmes, improved infection prevention strategies, and increasing clinical complexity, particularly in neonatal, oncohaematological, and intensive care settings. Clinical guidelines recommend blood cultures in neonates and infants with fever without a focus in children with sepsis or shock, with immunosuppression, suspected endovascular infection, meningitis, osteoarticular infections, or severe community-acquired pneumonia. Conversely, routine use is discouraged in clearly viral infections and in mild cases in previously healthy children. Available evidence consistently identifies the volume of blood inoculated as the main determinant of diagnostic performance, and this should be adjusted for age and weight. Obtaining one or two appropriately indicated peripheral blood culture sets, together with proper antisepsis, reduces contamination and improves clinical interpretation. Whenever feasible, both aerobic and anaerobic bottles should be included, given their complementary diagnostic yield. There is no robust evidence that paediatric bottles with smaller broth volumes provide substantial advantages over standard bottles when adequate blood volumes are inoculated. Importantly, no evidence demonstrates that the type of bottle or automated system used influences hospital stay, clinical outcomes, or mortality. This article presents an evidence-informed perspective that integrates current literature with expert clinical judgment, derived from more than four decades of experience at a high-complexity tertiary-care hospital. [ABSTRACT FROM AUTHOR]
ISSN:	02143429
DOI:	10.37201/req/159.2026