Inpatient healthcare‐associated bloodstream infections in older people

Abstract

chronic haemophilic arthropathy with normal synovial appearance. Due to patient mental health comorbidities, appointments with orthopaedic surgeons were not attended and conservative management with the addition of tranexamic acid continues. DiscussionPseudotumours are rarely seen among patients with haemophilia in Australia. These two cases represent the first cases of pseudotumours in two haemophilia treatment centres (one paediatric and one adult), which in total service over 200 patients with severe haemophilia. The cause in the first case was suspected to be secondary to repeated bleeds to the area, in combination with nonadherence to prophylaxis. The second case did not demonstrate a clear bleeding history, and given the development of a second pseudotumour while adherent to the prescribed regular prophylaxis, this points to an alternative biological process. The diagnosis should be considered in patient who present with symptoms refractory to typical therapy, non-adherence to therapy or with pathological fractures. MRI is the modality of choice to examine for pseudotumours, and clinicians should be mindful that a normal CT or X-ray does not exclude the disease. The ideal management of this condition is not known, and given the rarity of the condition the development of an international registry would be of benefit. References1 Lim MY, Nielsen B, Ma A, Key NS. Clinical features and management of haemophilic pseudotumours: a single US centre experience over a 30-year period. Haemophilia 2014; 20: e58-62. 2 Senol K, Tutuncu T, Yuksek YN, Ozdemir N, Guney Y, Kama NA. Management of a recurrent massive abdominal haemophilic pseudotumour with adjuvant radiotherapy. Haemophilia 2015; 21: 333-5. 3 Magailon M, Monteagudo J, Altisent C, Ibanez A, Rodriguez-Perez A, Riba J et al. Hemophilic pseudotumour: multicentre experience over a 25 year period. AbstractThis retrospective study describes inpatient healthcare-associated bloodstream infections (HABSI) in older adults and explores whether urinary catheters (presence/insertion/removal) were related to HABSI events. One hundred and sixty-seven HABSI events were identified, predominantly (124, 74%) with Gram-negative bacteria. HABSI was attributed to a urinary source in 110 patients (66%), with over half (63, 57%) of these associated with urinary catheters. Catheter-associated HABSI may be avoidable and potential preventative strategies are discussed. AbstractHealthcare encompasses multiple discourses to which health professionals, researchers, patients, carers and lay individuals contribute. Networks of patients and nonprofessionals often act collectively to build capacity, enhance access to resources, develop understanding and improve provision of care. This article explores the concept of health collectives and three notable examples that have had an enduring and profound impact in the Australian context.