Effective today (Wednesday, May 7, 2014) two new orders for pediatric blood culture will be available.  On average, providers are now ordering two sets (a set=1 aerobic and 1 anaerobic bottle) per episode of pediatric sepsis.  The first new order (Epic panel O104798) therefore allows ordering of 1-3 sets of pediatric blood cultures at the same time to speed order entry.

The second new order (Epic panel O10480) enables diagnosis of a catheter-related bloodstream infection (CRBSI).  In CRBSI, a catheter with a high bacterial burden seeds the bloodstream, which by dilution contains fewer of the same species of bacteria per unit volume.  A CRBSI can therefore be diagnosed with confidence if a separate venipuncture and catheter draw are cultured, both cultures are positive with the same organism, and the catheter culture is positive greater than or equal to two hours before the culture from the venipuncture.  Time to positivity will be reported on a per-set basis in day:hour:minute format, making comparison of time to positivity between sets possible by manual calculation.

This order should not be used for single or multiple draws from a catheter without the intention to diagnose CRBSI.  For catheter draws for regular blood culture use Epic order 7646 (Blood culture, Pediatric) or the new order panel above.

As shown below, the CRBSI panel is arranged such that most providers will uncheck the last two boxes in order to receive a single venipuncture and catheter culture.  Should a venipuncture not be achieved, the correct source should be entered and the order will be corrected by the microbiology laboratory.

Questions concerning testing can be directed to Bradley Ford, MD, PhD, Associate Medical Director of Microbiology (ext. 6-2990).