Positive blood culture is the gold standard for diagnosing bacteraemia and fungaemia, yet there is significant variability in aspects of performing and interpreting the test in children and neonates. Processing a blood culture can take several days, and includes use of semi-automated incubation with growth detection and a broad range of laboratory techniques such as Gram staining, phenotypic or molecular identification and antimicrobial susceptibility testing on a cultured isolate. Sensitivity and specificity of a blood culture and time-to-positivity depend on a number of factors related to host/pathogen interaction, collection and transport of the specimen to the laboratory and methods employed to process the specimen. Interpretation of a positive result relies on correlation of the identity of the cultured microorganism with the clinical assessment of the child.
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