Short Supply-Driven Modifications to Blood Culture Practice and Their Clinical Impact: A Single-Center Time-Series...

Area of Science:

• Clinical Microbiology
• Infectious Diseases
• Healthcare Management

Background:

• Blood cultures are critical for diagnosing bloodstream infections and guiding antimicrobial therapy.
• A global shortage of BD BACTEC™ blood culture bottles impacted diagnostic services at Saitama Medical Center.
• Clinicians altered testing protocols, prioritizing cultures and often submitting single sets or deferring tests.

Purpose of the Study:

• To analyze the impact of the blood culture bottle shortage on diagnostic practices and outcomes.
• To evaluate changes in blood culture submission counts, positivity rates, and contamination.
• To assess the maintenance of diagnostic quality and pathogen detection during the supply disruption.

Main Methods:

• A retrospective observational study analyzed blood culture data from January 1 to October 31, 2024.
• Key indicators included submission count, single-set rate, episode count, true-positivity, and contamination rates.
• Interrupted time-series analysis (segmented regression with Prais-Winsten adjustment) assessed trends before, during, and after the shortage.

Main Results:

• Weekly blood culture submissions significantly declined during the shortage (p = 0.005).
• Single-set submission rates increased (p = 0.025), while true-positivity rates rose significantly (p = 0.010), indicating improved yield per test.
• Contamination rates remained stable, and the distribution of key pathogens did not change, preserving diagnostic quality.

Conclusions:

• The blood culture bottle shortage resulted in reduced testing but enhanced diagnostic accuracy and maintained quality.
• These findings underscore the importance of diagnostic stewardship and adaptable protocols for managing supply chain disruptions.
• Data-driven strategies are essential to ensure sustained patient care quality during future shortages.