{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T04:52:24Z","timestamp":1783227144713,"version":"3.54.6"},"reference-count":16,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"unspecified","delay-in-days":294,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S2732494X25101733_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Assess clinical outcomes, knowledge, and attitudes about shortage mitigation interventions during a nationwide blood culture bottle shortage. We hypothesized that efforts to target ordering of blood cultures would not change patient-oriented outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X25101733_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective, noninferiority, multicenter study<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X25101733_as3\">\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Tertiary, rural healthcare system<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X25101733_as4\">\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>Eligible patients had any culture ordered before and after mitigation strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X25101733_as5\">\n                    <jats:title>Interventions:<\/jats:title>\n                    <jats:p>Mitigation strategies were rapidly implemented to preserve the availability of blood culture bottles for high-risk patients. Interventions included best practice advisories, algorithms, cascade questions, hard stops, education, and communication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X25101733_as6\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The primary composite outcome (death during hospitalization, death within 14 d after discharge, return to the emergency department (ED) or readmission within 14 d after discharge) occurred in 603 of 3,174 patients (19.0%) in the pregroup and 1,496 of 8,232 patients (18.2%) in the postgroup (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.321), meeting noninferiority in inverse probability treatment weight (IPTW) analysis. The groups were similar in secondary outcomes and in the subgroup with severe sepsis or septic shock. 69% of 41 survey respondents answered the case questions correctly. Regulatory pressure and patient status were the strongest drivers of blood culture ordering. Clinicians favored in-person communication, algorithms, and cascade over emails, daily huddles, and hard stops\/second signatures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X25101733_as7\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Implementation of mitigation strategies during the shortage was not associated with differences in outcomes including mortality, return to the ED, readmission, or length of stay. Preliminary evidence suggests that outcomes may not be affected by the absence of blood cultures in high-risk sepsis patients. If proven in future studies, sepsis recommendations could be rewritten to accommodate pretest probability for bacteremia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ash.2025.10173","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T07:57:08Z","timestamp":1761119828000},"source":"Crossref","is-referenced-by-count":1,"title":["Implementation of blood culture stewardship during a blood culture bottle shortage: a multicenter assessment"],"prefix":"10.1017","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6401-1303","authenticated-orcid":false,"given":"Kristen","family":"Sevilla","sequence":"first","affiliation":[{"name":"The Guthrie Clinic, Robert Packer Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5124-1781","authenticated-orcid":false,"given":"Orest","family":"Konyk","sequence":"additional","affiliation":[{"name":"The Guthrie Clinic, Robert Packer Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2001-9764","authenticated-orcid":false,"given":"Jon C.","family":"Rittenberger","sequence":"additional","affiliation":[{"name":"The Guthrie Clinic, Robert Packer Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8180-7652","authenticated-orcid":false,"given":"Karen S.","family":"Williams","sequence":"additional","affiliation":[{"name":"The Guthrie Clinic, Robert Packer Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"S2732494X25101733_ref6","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-021-06506-y"},{"key":"S2732494X25101733_ref1","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.01005-21"},{"key":"S2732494X25101733_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2023.154255"},{"key":"S2732494X25101733_ref4","unstructured":"4. CDC Health Alert Network. Disruptions in Availability of Becton Dickinson (BD) BACTEC\u2122 Blood Culture Bottles Blood Culture Bottles. https:\/\/emergency.cdc.gov\/han\/2024\/han00512.asp. Accessed August 26, 2024."},{"key":"S2732494X25101733_ref15","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.01082-24"},{"key":"S2732494X25101733_ref14","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa039"},{"key":"S2732494X25101733_ref8","unstructured":"8. Suleyman, G MN , Palavecino, E , Harrington, A , et\u00a0al. Blood culture bottle inventory management and clinical conservation during supply shortages. https:\/\/asm.org\/Guideline\/Blood-Culture-Shortages-Management-Diagnostic-Stew. Accessed August 26, 2024."},{"key":"S2732494X25101733_ref3","unstructured":"3. US Food and Drug Administration. Disruptions in Availability of BD BACTEC Blood Culture Media Bottles \u2013 Letter to Health Care Providers. https:\/\/www.fda.gov\/medical-devices\/letters-health-care-providers\/disruptions-availability-bd-bactec-blood-culture-media-bottles-letter-health-care-providers. Accessed August 26, 2024."},{"key":"S2732494X25101733_ref10","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01053-20"},{"key":"S2732494X25101733_ref5","unstructured":"5. CMS severe sepsis and septic shock: management bundle (Composite measure). https:\/\/cmit.cms.gov\/cmit\/#\/MeasureView?variantId=778&sectionNumber=1. Accessed May 30, 2025."},{"key":"S2732494X25101733_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2024.04.198"},{"key":"S2732494X25101733_ref7","unstructured":"7. IDSA. CDC\/IDSA Clinician Call BACTEC Blood Culture Bottle Shortage - Hosted in Partnership with ASM, SHEA and PIDS. https:\/\/www.idsociety.org\/multimedia\/clinician-calls\/cdcidsa-clinician-callbd-bactec-blood-culture-bottle-shortage\/. Accessed August 26, 2024."},{"key":"S2732494X25101733_ref16","first-page":"20","article-title":"Implementation of an evidence-based algorithm reduces blood culture overuse in an adult emergency department","volume":"1","author":"Pawlowicz","year":"2015","journal-title":"Gen Inter Med Clin Innova"},{"key":"S2732494X25101733_ref12","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2023.265"},{"key":"S2732494X25101733_ref13","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2023.249"},{"key":"S2732494X25101733_ref2","unstructured":"2. Beddard, C. Letter to BD BACTEC blood culture system users. https:\/\/www.fda.gov\/medical-devices\/letters-health-care-providers\/disruptions-availability-bd-bactec-blood-culture-media-bottles-letter-health-care-providerse2024-BD-BACTEC-BloodCulture-MediaSupply.pdf(medline.com). Accessed August 26, 2024."}],"container-title":["Antimicrobial Stewardship &amp; Healthcare Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2732494X25101733","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T07:57:11Z","timestamp":1761119831000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2732494X25101733\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025]]}},"alternative-id":["S2732494X25101733"],"URL":"https:\/\/doi.org\/10.1017\/ash.2025.10173","relation":{},"ISSN":["2732-494X"],"issn-type":[{"value":"2732-494X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]},"article-number":"e278"}}