Infectious diseases

Infection control data as presented on the MyHospitals website should not be used to rank hospitalsUpdated indicators of safety and quality for the 2011–12 financial year were released earlier this year by the National Health Performance Authority (NHPA) on the MyHospitals website (http://www.myhospitals.gov.au). These detail the reports received by the NHPA on a single outcome measure, Staphylococcus aureus bacteraemia (SAB), and a process measure, compliance with ...

Allen C Cheng FRACP, MPH, PhD · Emily Woolnough MB BS · Leon J Worth MB BS, FRACP, PhD · David V Pilcher MB BS, FRACP, FCICM

To the Editor: Despite evidence supporting the safety and benefits of influenza vaccination during pregnancy,1,2 half of pregnant women believe the influenza vaccine to be unsafe or are uncertain about its safety in pregnancy.3 Other studies report confusion among antenatal care providers about the safety of influenza vaccination during pregnancy, and cite the need for more professional education.4 To help address these safety concerns, the Western ...

Annette K Regan · Christopher C Blyth · Paul V Effler

To the Editor: Peripheral intravenous catheters (PIVCs) frequently cause Staphylococcus aureus bacteraemia, and a disproportionate number of episodes involve catheters that have been left in place for ≥ 4 days or have been inserted in emergencies.1 Other studies have shown similar results with catheters left in place for > 48 hours or not routinely replaced after emergency placements.2-4 At Canberra Hospital, we have followed all bloodstream infections (BSIs).5 Since 2002, ...

Peter J Collignon · Fiona J Kimber · Wendy D Beckingham · Jan L Roberts

In reply: We thank Collignon and colleagues for their letter regarding our study on peripheral intravenous catheter (PIVC)-associated Staphylococcus aureus bacteraemia.1 We agree with their comments. Both their data and ours support the potential importance of establishing a national standard for the insertion and management of PIVCs in Australia. Such a standard needs to address the basics of PIVC management: not inserting PIVCs unless required;2 ...

Rhonda L Stuart · M Lindsay Grayson · Paul D R Johnson

In reply: It is untrue that new recommendations for clinically indicated peripheral intravenous catheter (PIVC) replacement are based on phlebitis alone. A Cochrane systematic review considered catheter-related bloodstream infection (BSI) data from five randomised controlled trials (4806 patients) and found no evidence for the effectiveness of routine replacement (P = 0.64).1 The largest trial (3283 patients) studied both catheter-related BSIs and all-cause BSIs, finding no disadvantage to clinically ...

Claire M Rickard · Joan Webster · E Geoffrey Playford

As the World Health Organization regularly reminds us, neither the timing nor the severity of the next influenza pandemic can be predicted. So, when avian influenza A(H5N1) virus emerged and fatal human cases were detected in a number of countries from 2003 onwards, pandemic planning took centrestage. At that time, those tasked with writing and implementing pandemic plans had no easy reference or experience to draw ...

Gina Samaan

Time may be a scarce commodity in our busy lives but, in so many aspects of health and wellbeing, it is a supremely important one.

Astika Kappagoda

Low vitamin D levels may increase the risk of reactivation of TB, but there is relatively little evidence supporting the use of vitamin D supplementation.

A Stewart Truswell AO, MD, FRCP

Many questions remain unanswered about accurate vitamin D testing and interpretation, the benefits of supplementation, and potential harms of oversupplementation.

Anna P Ralph MPH, FRACP, PhD · Robyn M Lucas MB ChB, PhD, FAFPHM

Clinicians should sometimes just say no to the “just in case” peripheral intravenous catheter to reduce harm caused.

Claire Dendle · Rhonda L Stuart · Diana Egerton-Warburton

A 78-year-old man of Laotian descent develops the first Australian case of Histoplasma capsulatum septic arthritis while receiving treatment for seropositive rheumatoid arthritis.

Andrew S Jordan BSc(Med), MB BS, FRACP · Ruchir Chavada MD · Vanathi Nagendra MB BS · H Patrick McNeil MB BS, PhD, FRACP · Katherine Kociuba FRCPA, FRACP · Kathryn A Gibson BM BCh, FRACP, PhD

MERS-CoV has reached nine countries, and the risk to Australian Hajj pilgrims should not be underestimated.

Harunor Rashid · Osamah Barasheed · Robert Booy

Serotype 15A’s abrupt appearance in the Victorian population, along with its high-level antimicrobial resistance and increased mortality rate show the importance of continued enhanced surveillance of invasive pneumococcal disease.

Janet E Strachan · Stacey L Rowe · Eileen M Dunne · Geoffrey G Hogg

New South Wales prisons data add to previous findings which show that Indigenous and non-Indigenous Australians achieve similar hepatitis C treatment outcomes.

Jeffrey J Post · Andrew R Lloyd · Denise Monkley

To the Editor: Leptospirosis in Victoria can be acquired locally or overseas. The clinical manifestations range from asymptomatic disease to multiorgan failure. We performed a retrospective case review of 147 notifications of leptospirosis to the Victorian Department of Health during the period 2002–2012. We aimed to investigate the epidemiology, clinical features and outcomes of leptospirosis in this population and identify any differences between patients who acquired ...

Jason A Trubiano · Brett A Sutton · Lucinda J Franklin

We report the first known Australian case of probable neurobrucellosis, in a young feral-pig shooter who presented with episodic left-sided visual loss and left-sided numbness and headache. Treatment with intravenous ceftriaxone and oral rifampicin, doxycycline and trimethoprim–sulfamethoxazole resulted in a good clinical response.Clinical recordIn September 2011, a 29-year-old man from rural western Queensland suddenly developed left-sided visual loss. This lasted 15 minutes and was followed by ...

Wendy J Munckhof PhD, FRACP, FRCPA · Amy V Jennison BSc(Hons), PhD · John R Bates BAppSc, ADipComp · Ian Gassiep MB BS(Hons)

Objective: To describe human hydatid disease in Tasmania since 1996, the year that the state was declared provisionally hydatid-free.Design, setting and participants: Individuals with a new diagnosis or history of hydatid disease between January 1996 and July 2012 were identified through a number of sources including public health notifications, discharge coding from Tasmanian public hospitals, and the Royal Hobart Hospital pathology laboratory information ...

Jennifer A O’Hern MPHTM, MB BS, BMedSci · Louise Cooley MB BS, FRACP, FRCPA

A case-note audit at a community-based sexual health clinic has shown that hepatitis C treatment outcomes among Indigenous Australians are similar to those among non-Indigenous Australians, which might be partly due to genetics.

Joshua S Davis · Anuja C Kulatunga · Krispin Hajkowicz

To the Editor: We report a case of severe Vibrio cholerae infection acquired in Sydney, likely due to ingestion of imported seafood. An 83-year-old man with Parkinson disease presented with a 3-day history of vomiting, large-volume watery diarrhoea and acute renal impairment necessitating admission to the intensive care unit. Blood cultures grew curved gram-negative bacilli, and intravenous piperacillin–clavulanic acid was commenced. Subsequent microbiological testing of blood ...

Chiao-Yun Hsu · Simon Pollett · Patricia Ferguson · Brenden J McMullan · Vicki Sheppeard · Suzanne E Mahady

Children in two remote Northern Territory Aboriginal communities were studied to measure the impact of four weeks of daily swimming on rates of ear discharge with a tympanic membrane penetration and on the microbiology of the nasopharynx and middle ear.

Anna T N Stephen MPH · Amanda J Leach BAgSc(Hons), MAgSc, PhD · Peter S Morris MB BS, PhD, FRACP