Experience with alternative operations under limited blood culture bottle supplies

Abstract

The supply restriction of blood culture bottles (Bactec) that occurred in July 2024 had a significant impact on the testing system in Japan. In our center, in order to maintain the current two-set collection rate during the restriction period, Bactec was used for the first set and Signal was used as a substitute for the second set (439 cases). The positive rate was 16.2%, of which 45.1% were positive for both sets, 42.3% were positive for only the first set, and 12.7% were positive for only the second set. The detected bacterial species were almost the same for both sets, but the time it took to become positive was slower for the second set, with 46.7% being delayed by more than half a day. In all cases with positive blood cultures, the infection control team intervened, and looking at whether or not antibiotics were changed in the 64 cases excluding contamination and death, the antibiotics used were appropriately changed in 13 of the 33 cases with 1 positive set (39.4%). In contrast, in the case of 2 positive sets, the rate was significantly higher at 23 of the 31 cases (74.2%) (p = 0.032), indicating that the number of positive sets has a large impact on the decision to change antibiotics. and antibiotic adsorption functions, we believe that it has played a role as an alternative. We must not allow any interruption in medical treatment or inconvenience to patients. We hope that this emergency will serve as an opportunity to consider how laboratories can operate without compromising on quality.