This study states that In hospitalized children, severe sepsis is common (8.2% prevalence) and deadly (25% mortality rate) (1,2). Bacterial bloodstream infections are an important cause of sepsis, and blood cultures are the gold standard for diagnosing bacteremia. Blood cultures are typically coupled with empiric antibiotics, and results guide subsequent therapy. Delayed initiation of broad-spectrum antibiotics increases morbidity and mortality (3). Accordingly, pediatric hospitals now prioritize early sepsis recognition and rapid antibiotic administration as key performance metrics (4). Rapid diagnosis of bacterial sepsis is clearly beneficial, but in practice, PICU clinicians are faced with two important challenges: the nonspecific nature of presenting symptoms of sepsis in children and the limitations of blood cultures as a diagnostic test. In children, clinical symptoms like fever or leukocytosis are neither sensitive nor specific for infection, and no single biomarker or decision rule can perfectly identify patients likely to have bacteremia. Hence we conclude that Blood cultures, perceived as a low-risk test for a disease with potentially fatal outcomes, are subject to excessive use with a low threshold in PICUs, as well as in other healthcare settings. 

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