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

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.