Page 3 of 7: Conserve blood culture bottles to maintain supply

On June 18, we shared a message informing physicians of a global shortage of BD blood culture bottles impacting our St. Joseph’s and St. Michael’s sites and requesting that clinical staff and physicians follow best practices for blood culture draws to help us maintain our supplies. We also shared this message to all staff, via Twice a Week.

Since sending these messages, we have not seen a change in usage levels across the two acute care sites. It is imperative that we work together to minimize unnecessary blood draws and help prevent a more significant supply issue.

Please help us by following these best practices:

1. Collect two sets of blood cultures (one aerobic and one anaerobic bottle) for each febrile episode within 24 hours. Take up to three sets if there is a high suspicion of endocarditis in adults. Please review previous orders to avoid duplicate collections.
2. Pay close attention to the fill volume to meet 8-10 mL per bottle for adults. For pediatric patients, follow the volume collection guidelines.
3. Closely adhere to aseptic technique (disinfecting the bottle stopper) and skin preparation.
4. Favour collections from peripheral venipuncture sites.
5. Repeat blood cultures are only warranted to test for clearance of select patients (i.e. staphylococcus aureus, candida species blood stream infections, patients with endocarditis). Test for clearance is not required for patients with gram negative bacteremias with clinical improvement.
6. Do not inoculate blood culture bottles at the bedside with other sterile bodily fluids. Instead, aseptically collect and send the fluid in sterile containers.

We will continue to share updates, as needed. Thank you for your assistance in this important matter.

Original message below

Date: June 18, 2024

Subject: Key actions to conserve blood culture bottles

We were recently informed of a global supply chain disruption to BD blood culture bottles. This shortage is impacting all Canadian hospitals and blood collection centres that use BD supplies. We anticipate the shortage to last for the next three months, at minimum, and we are collaborating with other organizations and the vendor for alternatives.

To conserve our supply of blood culture bottles at Unity Health Toronto, it is essential that you follow these best practice recommendations for blood culture draws:

1. Collect two sets of blood cultures (one aerobic and one anaerobic bottle) for each febrile episode within 24 hours. Take up to three sets if there is a high suspicion of endocarditis in adults. Please review previous orders to avoid duplicate collections.
2. Pay close attention to the fill volume to meet 8-10 mL per bottle for adults. For pediatric patients, follow the volume collection guidelines.
3. Closely adhere to aseptic technique (disinfecting the bottle stopper) and skin preparation.
4. Favour collections from peripheral venipuncture sites.
5. Repeat blood cultures are only warranted to test for clearance of select patients (i.e. staphylococcus aureus, candida species blood stream infections, patients with endocarditis). Test for clearance is not required for patients with gram negative bacteremias with clinical improvement.
6. Do not inoculate blood culture bottles at the bedside with other sterile bodily fluids. Instead, aseptically collect and send the fluid in sterile containers.

As we currently have limited control over blood culture bottle supply, the main way we can help is to minimize unnecessary blood culture draws. These conservation efforts must continue over the coming months to help prevent a negative impact on patient care.

We will provide updates regularly. We appreciate your assistance in helping to stretch our supply as we work through this global supply chain shortage.