• Posted July 24, 2024

CDC Warns of Shortage of Bottles Needed for Crucial Blood Tests

Hospitals and clinical laboratories across the United States are facing a critical shortage of bottles used to culture blood samples, federal health officials report.

Without the ability to culture blood, patients might receive the wrong antibiotics to treat conditions like endocarditis, sepsis and catheter-related blood infections, the U.S. Centers for Disease Control and Prevention warned in a recent health advisory.

“Without the ability to identify pathogens or [their susceptibility to specific antibiotics], patients may remain on broad antibiotics, increasing the risk of antibiotic resistance and Clostridium difficile-associated diarrhea,” Dr. Krutika Kuppalli, a spokeswoman for the Infectious Diseases Society of America, told STAT.

“Shortages may also discourage ordering blood cultures, leading to missed infections that need treatment,” Kuppalli added.

The shortage of Becton Dickinson (BD) Bactec blood culture media bottles has been going on for weeks, and the company has warned that it could stretch into September.

Most blood cultures in this country are performed using continuous-monitoring blood culture systems, the CDC said. These systems can operate unattended by a lab worker, and sound an alert when a foreign microorganism is detected in a blood culture.

The BD continuous-monitoring blood culture system is used in about half of all U.S. laboratories, and is only compatible with its own BD Bactec blood culture media bottles, the CDC noted.

BD first alerted health care providers in mid-June about a “reduced availability of plastic bottles from our supplier that has prevented us from manufacturing BD Bactec media to meet full global demand.”

“We understand the critical role that blood culture testing plays in diagnosing and treating infections and are taking all available measures to address this important issue,” BD Diagnostic Solutions President Nikos Pavlidis said in a recent news release.

The company has asked its former supplier of glass vials to restart production and help fill in the supply gaps, Pavlidis said.

In the meantime, “BD Bactec blood culture vials are being allocated manually so we can best mitigate any impact to patient care,” he added.

Medical experts speaking in a webinar hosted by the CDC and the Infectious Diseases Society of America said the shortage is affecting hospital and lab operations, warning that some places might run out of bottles completely, CNN reported.

The microbiology lab at Vanderbilt University Medical Center (VUMC) in Nashville -- a 1,700-bed hospital -- received only 10 bottles in its shipment this week, lab medical director Romney Humphries said during the webinar.

As a result, VUMC has less than a week's worth of blood culture bottles on hand, and completely running out is a "very real possibility," Humphries noted.

In the meantime, the CDC is urging hospitals to cut back on blood culture tests, preserving them for cases most in need of a culture.

“Several studies have demonstrated that unnecessary blood cultures can be reduced without an increase in adverse events,” the CDC said. “These studies can serve as a template for collaborative efforts to reduce the number of unnecessary blood cultures performed in healthcare facilities.”

Humphries said measures put in place by her medical center have reduced the use of the scarce bottles by about 58%.

“I don’t think it makes any of us happy that we’re doing this, by any means, and I think it’s fairly important to say that that is absolutely not the standard of care, but we’ve been forced into a situation where we can’t provide the standard of care for this shortage,” Humphries said.

“It does become a risk decision -- is no blood cultures for any patient worse or better than having one set for all patients, and it’s an extremely difficult thing,” Humphries added.

More information

Kaiser Permanente has more on blood culture tests.

SOURCE: U.S. Centers for Disease Control and Prevention, news release, July 10, 2024; CNN