The CDC just put out a Health Alert Network advisory about the shortage of BD BACTEC blood culture vials, which could make it harder to diagnose some infections and mess with antimicrobial stewardship efforts.
“Blood cultures are super important for helping doctors diagnose things like bloodstream infections, endocarditis, catheter-related infections, and sepsis,” the CDC said. “They help identify the bugs causing these infections, and then we can figure out the best treatment.”
Most U.S. blood culture systems, like BD’s, are used in about half of labs and only work with BD BACTEC vials. The shortage was added to the FDA’s list of medical device shortages on July 10.
BD Hopes Supply Will Get Better in September
During a call hosted by the CDC and the Infectious Diseases Society of America (IDSA), BD Life Sciences VP Chris Beddard said that manufacturing issues with their supplier have impacted the supply of vials in the U.S. and globally. However, she mentioned that more vials should be available by September. BD is working with the FDA and their supplier to boost production, manage supply distribution, and speed up shipping. They had already notified customers about the shortage in June.
To help with availability, BD has temporarily substituted glass bottles for the plastic anaerobic culture vials and hopes to have them in the U.S. market by early September.
What the CDC Recommends Right Now
The CDC is urging healthcare providers and labs to take steps to prevent contamination of blood cultures, ensure enough blood is collected for accurate results, and avoid unnecessary tests and extra blood draws that would use up more vials.
“Studies have shown that unnecessary blood cultures can be cut down without causing any harm to patients,” the CDC pointed out. They also shared a quality tool to help reduce contamination and improve test accuracy.
Earlier this month, the FDA also sent a letter to healthcare providers recommending they prioritize blood culture tubes for patients showing signs of bloodstream infections, follow proper skin disinfection protocols before collecting blood, and use safe devices to avoid damaging the vials. They also urged providers to report any issues.
Labs and facilities facing the shortage should explore other options, like partnering with nearby labs or sending samples to labs that aren’t affected. The advisory also suggests setting up teams of lab and clinical experts to figure out how to best use the limited supply.
Health departments should connect with hospitals and labs to see how the shortage might impact them, educate them on the best use of blood cultures, and help arrange for sharing vials or using unaffected labs.
Cutting Back on Blood Cultures and Second Cultures
On the clinician call, Johns Hopkins doctors Valeria Fabre and Aaron Milstone noted that around 90% of blood cultures from adult hospital patients come back negative. They shared an evidence-based algorithm that helps determine when blood cultures are really needed.
Using this approach, they estimated that about 30% of blood cultures in their ICU and 50% on other floors weren’t necessary.
