{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:47:10Z","timestamp":1791985630367,"version":"4.4.0"},"reference-count":21,"publisher":"American Society for Microbiology","issue":"10","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2026,10,14]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      During the 2024 US national blood culture bottle shortage, many hospitals implemented restrictions limiting blood culture collection to conserve supplies. The impact of these constraints on the microbiologic epidemiology of bloodstream infections (BSIs) remains incompletely characterized. We conducted an interrupted time series analysis of BSI episodes identified at two quaternary hospitals between June 2023 and June 2025, encompassing a systemwide restriction limiting clinicians to one blood culture set per patient every 24 h from June through December 2024. We grouped blood cultures into discrete infection episodes and categorized these by organism group. We normalized monthly incidence rates to acute-care patient-days and used segmented Poisson regression models to estimate changes in incidence associated with restriction onset and withdrawal. We identified 5,391 BSI episodes among 4,484 patients. During the restriction period, the relative proportion of episodes due to enterococci, fungi, gram-negative rods, and\n                      <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>\n                      \/\n                      <jats:italic toggle=\"yes\">lugdunensis<\/jats:italic>\n                      increased, whereas episodes due to anaerobes, streptococci, coagulase-negative staphylococci\/common commensals, and polymicrobial infections decreased. Interrupted time series analyses demonstrated an overall decline in detected BSI incidence, with statistically significant decreases observed for streptococci and gram-negative rods. Estimates for other groups were limited by small numbers and imprecision. Blood culture restrictions during a national supply shortage were associated with measurable shifts in the detected distribution of bloodstream pathogens and reduced overall BSI detection. These findings suggest that diagnostic constraints may selectively impair detection of certain organism groups, with important implications for laboratory surveillance, antimicrobial stewardship, and interpretation of microbiologic trends during periods of constrained testing.\n                    <\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>\n                        Blood cultures remain the primary method for diagnosing bloodstream infections and tracking causative pathogens. During the 2024 national blood culture bottle shortage, many hospitals limited blood culture collection to conserve supplies. While prior studies focused on changes in testing volume or clinical outcomes, it has remained unclear how these restrictions affected which organisms were ultimately detected. Here, we examined how the shortage influenced the observed distribution of major bloodstream pathogens, including\n                        <jats:italic toggle=\"yes\">Staphylococcus aureus\/lugdunensis<\/jats:italic>\n                        , gram-negative rods, streptococci, enterococci, anaerobes, fungi, and coagulase-negative staphylococci\/common commensals. Restricting blood culture collection was associated with a decline in overall detected bloodstream infections and shifts in the relative frequency of specific organism groups. These findings suggest that limitations in diagnostic testing can distort microbiologic surveillance data and alter the apparent epidemiology of bloodstream pathogens. Laboratories, clinicians, and surveillance systems should consider how supply disruptions and subsequent testing policies may influence the organisms identified in clinical practice.\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/jcm.00296-26","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:13:11Z","timestamp":1790345591000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Changes in observed bloodstream infection epidemiology during a single-set blood culture restriction: an interrupted time series analysis"],"prefix":"10.1128","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2461-2752","authenticated-orcid":true,"given":"Joseph B.","family":"Ladines-Lim","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00b30xv10","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Infectious Diseases, Department of Medicine, Penn Medicine, Perelman School of Medicine, University of Pennsylvania","place":["Philadelphia, USA"]},{"id":[{"id":"https:\/\/ror.org\/00b30xv10","id-type":"ROR","asserted-by":"publisher"}],"name":"Leonard Davis Institute of Health Economics, University of Pennsylvania","place":["Philadelphia, USA"]},{"id":[{"id":"https:\/\/ror.org\/00b30xv10","id-type":"ROR","asserted-by":"publisher"}],"name":"Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania","place":["Philadelphia, USA"]}],"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":"Division of Infectious Diseases, Department of Medicine, Penn Medicine, Perelman School of Medicine, University of Pennsylvania","place":["Philadelphia, USA"]},{"id":[{"id":"https:\/\/ror.org\/00hj8s172","id-type":"ROR","asserted-by":"publisher"}],"name":"Fu Foundation School of Engineering and Applied Science, Columbia University","place":["New York, USA"]}],"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":"Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warren B.","family":"Bilker","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00b30xv10","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Biostatistics, Epidemiology, amd Informatics, Perelman School of Medicine, University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen O.","family":"Degnan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00b30xv10","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Infectious Diseases, Department of Medicine, Penn Medicine, Perelman School of Medicine, University of Pennsylvania","place":["Philadelphia, USA"]}],"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":"Division of Infectious Diseases, Department of Medicine, Penn Medicine, Perelman School of Medicine, University of Pennsylvania","place":["Philadelphia, USA"]},{"id":[{"id":"https:\/\/ror.org\/00b30xv10","id-type":"ROR","asserted-by":"publisher"}],"name":"Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania","place":["Philadelphia, USA"]},{"id":[{"id":"https:\/\/ror.org\/00b30xv10","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Biostatistics, Epidemiology, amd Informatics, Perelman School of Medicine, University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae104"},{"key":"e_1_3_5_3_2","unstructured":"U.S. Food & Drug Administration. 2024. FDA roundup. https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-roundup-july-12-2024."},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae402"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaf546"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2025.102664"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2025.60"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaf498"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.35580"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2025.10310"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2025.83"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1017\/ash.2025.10186"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaf294"},{"key":"e_1_3_5_14_2","doi-asserted-by":"crossref","unstructured":"Ladines-Lim JB Van B Cressman L Bilker WB Glaser L Degnan KO David MZ. 2026. Impact of a single-set blood culture restriction during the 2024 national blood culture bottle shortage on patient outcomes: an interrupted time series analysis. Infection Control & Hospital Epidemiology (in press).","DOI":"10.1101\/2025.09.24.25335834"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.13836"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000735"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.2307\/1913610"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.2307\/2951684"},{"key":"e_1_3_5_19_2","unstructured":"R Core Team. 2023. R: a language and environment for statistical computing. Vienna Austria."},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics9020096"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01005-21"}],"container-title":["Journal of Clinical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/jcm.00296-26","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/jcm.00296-26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:03:42Z","timestamp":1791983022000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/jcm.00296-26"}},"subtitle":[],"editor":[{"given":"Daniel J.","family":"Diekema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,10,14]]},"references-count":21,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10,14]]}},"alternative-id":["10.1128\/jcm.00296-26"],"URL":"https:\/\/doi.org\/10.1128\/jcm.00296-26","relation":{},"ISSN":["0095-1137","1098-660X"],"issn-type":[{"value":"0095-1137","type":"print"},{"value":"1098-660X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,14]]},"assertion":[{"value":"2026-02-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e00296-26"}}