Yield of Blood Culture in Pediatric Emergency Department

Background: Blood cultures are routinely used in pediatric emergency departments (EDs) to detect bloodstream infections, but their diagnostic yield and clinical utility remain variable. Objectives:To assess the diagnostic yield of blood cultures in a pediatric ED and to evaluate the associated clinical characteristics, diagnoses, and outcomes of patients undergoing testing.Methods: This prospective observational study was conducted in the Pediatric Emergency Department from January 2023 to January 2024.Children aged 1 month to 18 years who underwent blood culture testing were enrolled.Clinical data, laboratory results, and outcomes were recorded and analysed.Results: Of the 716 children included, 94 (13.1%) had positive blood cultures, while 622 (86.9%) were negative.Among the positives, 8.8% were true pathogens and 4.3% were contaminants.Blood cultures were most frequently obtained for gastrointestinal and respiratory symptoms.Salmonella typhi (39.7%) and Streptococcus pneumoniae (15.9%) were the most common pathogens.Coagulase-negative Staphylococci (48.4%) and Pseudomonas spp.(9.7%) were the leading contaminants.Bacterial infections accounted for 72% of positive cultures, with enteric fever, community-acquired pneumonia (CAP), septicaemia, and surgical conditions such as acute appendicitis being the most frequent diagnoses.The diagnostic yield for blood cultures in CAP was low (5.18%).Incomplete immunization showed a trend toward increased bacteraemia risk (p = 0.085).Culture yield varied significantly by timing of collection (day vs. night; p = 0.0045) and monthly admission patterns (p = 0.047). Conclusions:The diagnostic yield of blood cultures in the pediatric ED was moderate, with a substantial proportion representing contaminants.Enteric fever was the most common bloodstream infection.Optimizing the volume and adherence to strict aseptic precautions during collection of blood culture may enhance diagnostic accuracy and reduce contamination rates.