Table 2.

Consensus recommendations for blood culture practices in symptomatic immunocompetent critically ill children, WITH and WITHOUT a central venous catheter

Recommendation		% In Agreement with recommendation*
9	Avoid blood culture in patients with a viral syndrome (such as bronchiolitis), NEW fever, no signs of sepsis, and WITHOUT central venous catheter in place.	85% (23/27)
10	Avoid blood culture in patients with a viral syndrome (such as bronchiolitis), PERSISTENT fever within expected time course for viral infection, no signs of sepsis, and WITHOUT central venous catheter in place.	89% (24/27)
11	Avoid blood culture in patients with a localized bacterial source of infection (e.g., urinary tract infection or focal pneumonia), PERSISTENT and expected fever, no signs of sepsis, at least one negative blood culture obtained since the start of fever, and WITHOUT a central venous catheter.	81% (22/27)
12	Avoid blood culture in patients with NEW fever, no signs of sepsis, and with symptoms of withdrawal while undergoing wean of sedative/opioid infusions, and WITHOUT a central venous catheter in place.	88% (23/26)
13	Avoid repeat blood cultures in patients with a symptomatic viral infection (such as bronchiolitis), PERSISTENT fever within expected time course for this viral infection, no signs of sepsis, and who has already had at least one negative blood culture obtained since the start of fever, WITH central venous catheter in place.	100% (27/27)
14	Avoid blood culture in patients with a documented localized bacterial infection (e.g., urinary tract infection or focal pneumonia), PERSISTENT and expected fever, no signs of sepsis, and who has a blood culture that is negative to date obtained within the last 48 hours, and WITH a central venous catheter.	100% (27/27)
15	For PERSISTENT fever in immunocompetent patients WITH a central venous catheter, suspected non-infectious etiology of fever and no documented source of infection, without signs of sepsis, and with initial set of negative blood cultures, avoid additional blood cultures.	78% (21/27)
16	Avoid blood culture in patients with NEW fever, no signs of sepsis, and with symptoms of withdrawal while undergoing wean of sedative/opioid infusions, WITH a central venous catheter in place, who defervesces in response to treatment for withdrawal.	100% (26/26)
17	For PERSISTENT fever in patients WITH central venous catheter and without signs of sepsis, if a recent set of blood cultures from the catheter is no growth to date, then subsequent cultures, if indicated, do not need to be drawn from the catheter.	96% (25/26)

^*Denominator varies slightly due to unanswered items on a small number of surveys analyzed, with a possible total of 29 responses