Critical shortages of blood culture vials, or “bottles,” used for blood culture (BC) collection occur infrequently due to a variety of supply chain and quality control hurdles. Some shortages may affect a single medium type, while others may broadly impact entire lines of supplies (i.e. aerobic, anaerobic, pediatric, mycobacterial and fungal bottles) for a given instrument or manufacturer. Acquiring new instrumentation or pivoting to a different supply line from a different manufacturer can take months due to contracting and availability of alternative options. Therefore, managing supplies during such shortages mainly relies on thoughtful use, stewardship of available reagents and, during severe shortages, may require reducing use below that of standard of care best practices.
In this document, we 1) provide practical recommendations for how to approach institution- or system-level coordination to manage BC bottle inventory and patient testing during shortages, 2) provide practical recommendations for how to optimize test quality to reduce the need for specimen recollection and 3) summarize published guidelines and diagnostic stewardship studies that exemplify common opportunities for stewardship of BCs that can improve patient care during routine practice and may especially be considered for implementation during shortages to help conserve supplies for the most clinically necessary indications. We also review the test performance data behind some best practice standards that healthcare systems may consider modifying or foregoing to reduce testing during contingency or crisis management.
We aim to provide a comprehensive review of best practices. However, when moving beyond best practices, we encourage users to consider the stage and severity of the shortage in their system and work collaboratively with clinical leadership to weigh the benefits and risks of non-best practice interventions.
This guideline was developed on behalf of the American Society for °®¶¹´«Ã½ Clinical and Public Health °®¶¹´«Ã½ Committee, Laboratory Practices Subcommittee and was endorsed by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA).
In this document, we 1) provide practical recommendations for how to approach institution- or system-level coordination to manage BC bottle inventory and patient testing during shortages, 2) provide practical recommendations for how to optimize test quality to reduce the need for specimen recollection and 3) summarize published guidelines and diagnostic stewardship studies that exemplify common opportunities for stewardship of BCs that can improve patient care during routine practice and may especially be considered for implementation during shortages to help conserve supplies for the most clinically necessary indications. We also review the test performance data behind some best practice standards that healthcare systems may consider modifying or foregoing to reduce testing during contingency or crisis management.
We aim to provide a comprehensive review of best practices. However, when moving beyond best practices, we encourage users to consider the stage and severity of the shortage in their system and work collaboratively with clinical leadership to weigh the benefits and risks of non-best practice interventions.
This guideline was developed on behalf of the American Society for °®¶¹´«Ã½ Clinical and Public Health °®¶¹´«Ã½ Committee, Laboratory Practices Subcommittee and was endorsed by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA).
Contact Information
ASM's Clinical and Public Health °®¶¹´«Ã½ Committee, clinmicro@asmusa.org