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. 2025 Sep 10:ciaf498.
doi: 10.1093/cid/ciaf498. Online ahead of print.

The Impact of a Nationwide Blood Culture Bottle Shortage in 2024 on Healthcare Facilities in the United States

Joseph D Lutgring  1 , Alexander Maillis  1   2 , George C Bryant  1   3 , Kathryn A Haass  1 , Marissa McMeen  1   3 , Henrietta Smith  1 , Natalie L McCarthy  1 , Kelly M Hatfield  1 , L Clifford McDonald  1 , Sujan C Reddy  1 , Arjun Srinivasan  1 , Margaret Dudeck  1 , Hannah Wolford  1
Affiliations

The Impact of a Nationwide Blood Culture Bottle Shortage in 2024 on Healthcare Facilities in the United States

Joseph D Lutgring et al. Clin Infect Dis. .

Abstract

Background: A shortage of BD BACTECTM blood culture bottles occurred in 2024. We describe the clinical impact of that shortage.

Methods: We conducted a National Healthcare Safety Network (NHSN) questionnaire and retrospective cohort study using inpatient hospitalization data from the Premier Healthcare Database. In the retrospective cohort, facilities were categorized into BD BACTEC™ (n = 11) and non-BD BACTEC™ (n = 28) hospitals; non-shortage and shortage periods were considered from May 2023 to June 2024 and July to November 2024. We used a generalized linear model for the rate of blood cultures with an offset for patient days and adjusted for facility characteristics and other factors. Similarly, we modeled the rate of unique adult hospitalizations with a pathogen-positive blood culture per hospitalization.

Results: Of 3196 facilities responding, 1453 (45.6%) indicated a use of BD BACTECTM to the NHSN questionnaire; of those, 1103 (75.8%) reported a shortage impact. In the retrospective cohort study, there was a 27.4% decrease in cultures at BD BACTEC™ hospitals during the shortage period (95% CI: -31.2% to -23.4%). BD BACTEC™ facilities had a median change in culturing rate of -33.3% (IQR: -47.0% to 2.0%) between the non-shortage and shortage periods. There was a 15.3% decrease in the rate of patients positive for a pathogen at affected facilities during the shortage (95% CI: -22.4% to -7.5%).

Conclusions: BD BACTEC™ facilities experienced substantial and non-uniform decreases in blood culture rates. Impacted facilities had a decrease in the rate of observed bloodstream infections, which has implications for patient safety and surveillance.

Keywords: blood culture bottles; blood cultures; diagnostic stewardship; questionnaire; supply shortage.

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Conflict of interest statement

J.D.L. reports institutional support for travel to the Society for Healthcare Epidemiology of America Spring meeting and Clinical and Laboratory Standards Institute antimicrobial susceptibility testing subcommittee meetings. All other authors report no conflicts of interest.

Figures

Figure 1
Figure 1. Blood Culture Rates among Becton Dickinson (BD) BACTEC™ and non-BD BACTEC™ Facilities in the Premier Healthcare Database between May 2023 and November 2024
Figure 1A: Overall blood culture rates per 1,000 patient days, Figure 1B: admission blood culture rates per 1,000 hospitalizations, Figure 1C: post-admission blood culture rates per 1,000 patient days, Figure 1D: Intensive care unit (ICU)and non-ICU blood culture rates per 1,000 ICU and non-ICU patient days, respectively, * BD BACTEC™ facilities (n=11) and non-BD BACTEC™ facilities (n=28)
See this image and copyright information in PMC

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