{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:49:58Z","timestamp":1791809398556,"version":"4.3.4"},"reference-count":43,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X26105273_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the clinical and stewardship consequences of a single-set blood culture restriction implemented during the 2024 national blood culture bottle shortage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105273_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Interrupted time series analysis of hospitalizations from June 26, 2023, to June 25, 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105273_as3\">\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Two tertiary hospitals in an urban academic health system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105273_as4\">\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>116,341 inpatient hospitalizations, including 31,034 with \u22651 blood culture obtained.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105273_as5\">\n                    <jats:title>Intervention:<\/jats:title>\n                    <jats:p>A systemwide electronic health record order restriction from June 26 to December 23, 2024, limiting clinicians to one blood culture set per patient every 24 hours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105273_as6\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In-hospital mortality or hospice discharge declined before restriction (\u22121.3%\/week;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), flattened during restriction (+0.8%\/week;\n                      <jats:italic>P<\/jats:italic>\n                      = .20), and declined again after restriction (\u22122.8%\/week;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). Overall blood culture positivity increased from 9.6% prerestriction to 11.2% during restriction and decreased to 10.2% postrestriction. Upon restriction onset, hospitalizations with \u22651 blood culture decreased 29.7% (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). Among hospitalizations with \u22651 blood culture, mean cultures per hospitalization decreased 52.6% (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), time to first culture increased 39.5% (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), and time to first antimicrobial increased 13.8% (\n                      <jats:italic>P<\/jats:italic>\n                      = .04). Days of antimicrobial therapy increased among hospitalizations with and without blood cultures by 12.6% (\n                      <jats:italic>P<\/jats:italic>\n                      = .001) and 10.6% (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105273_as7\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>A near-universal single-set blood culture restriction was associated with decreased and delayed diagnostic testing, delayed antimicrobial initiation, increased antimicrobial exposure, and temporal changes in clinical outcomes. Crisis-driven diagnostic stewardship interventions should include indication-specific guidance and real-time safety monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2026.10527","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:39:00Z","timestamp":1787801940000},"page":"1053-1063","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Impact of a single-set blood culture restriction during the 2024 national blood culture bottle shortage on patient outcomes: an interrupted time series analysis"],"prefix":"10.1017","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2461-2752","authenticated-orcid":false,"given":"Joseph B.","family":"Ladines-Lim","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00b30xv10","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Pennsylvania"},{"id":[{"id":"https:\/\/ror.org\/00b30xv10","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Pennsylvania"},{"id":[{"id":"https:\/\/ror.org\/00b30xv10","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bailey","family":"Van","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00b30xv10","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Pennsylvania"},{"name":"Columbia University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh","family":"Cressman","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00b30xv10","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warren B.","family":"Bilker","sequence":"additional","affiliation":[{"name":"University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurel","family":"Glaser","sequence":"additional","affiliation":[{"name":"University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Degnan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00b30xv10","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Z.","family":"David","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00b30xv10","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Pennsylvania"},{"id":[{"id":"https:\/\/ror.org\/00b30xv10","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Pennsylvania"},{"name":"University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"S0899823X26105273_ref37","doi-asserted-by":"publisher","DOI":"10.2307\/2951684"},{"key":"S0899823X26105273_ref9","unstructured":"9. 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Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}