Human ; Environment ; Work ; Philippines

BACKGROUND

Rabies remains to be a neglected tropical disease in the Philippines, with the country reporting a higher number of cases compared to its counterparts in Asia.

To describe the demographics, animal bite characteristics, and post-exposure prophylaxis of animal bite patients coming in for care at the Research Institute for Tropical Medicine (RITM), a large government referral center for infectious diseases, and animal bites.

Electronic patient records from January 1, 2018 to December 31, 2019 were obtained from the National Rabies Information System (NaRIS) database of the Department of Health, and summarized using applicable descriptive statistics.

A total of 14,614 patients were included over the two-year study period, and more than third of the patients were children below 15 years old, while more than half were adult males. Lower extremities were the most frequently affected area, while with children, more than a third of exposures were in the head and neck areas. Intradermal route was mostly used for the post-exposure prophylaxis, while WHO prequalified vaccines were utilized in more than 90% of the patients. Only 55.7% of patients completed the prophylaxis regimen at RITM.

These findings reflect the significant exposure of children from animal bites, and the non-compliance of patients to the prescribed post-exposure prophylaxis.

OBJECTIVE

To determine the prevalence of rectal colonization with carbapenem-resistant organisms (CRO) among PGH neonatal intensive care unit (NICU) patients.

A prospective single-center observational study conducted over a 1-month period included all NICU 3 and cohort area patients admitted on April 24, 2024. Rectal swabs were collected for multidrug-resistant organism (MDRO) screening and repeated weekly for 1 month while admitted. Swabs were inoculated on chromogenic media, and isolates were identified and tested for antimicrobial sensitivity by disk diffusion. Clinical characteristics and outcomes were collected for 30 days from initial MDRO screening. Descriptive statistics were used to summarize the data.

The point prevalence of CRO colonization was 37% (14 of 38) at initial screening. There were 14 incident colonizations, hence the 4-week period prevalence of CRO colonization was 72.5% (29 of 40). The patients were mostly very preterm, very low birth weight neonates, majority were tested within the first 2 weeks of life, and half were exposed to meropenem at initial screening. Nosocomial infection developed in 29% and 64%, and 30-day mortality rate was 8% and 21% among initially non-CRO-colonized and CRO-colonized patients respectively. Despite high CRO colonization, no culture-proven CRO infection was observed. Surveillance screening documented persistent CRO colonization in 37%, but no decolonization. Escherichia coli, Klebsiella spp. and Serratia spp. were the most common colonizers.

The high prevalence of rectal CRO colonization in the NICU emphasizes the burden of antimicrobial resistance, but despite the high CRO colonization, no CRO infection was documented from the limited sample and study period.

BACKGROUND

The use of ceftazidime-avibactam (CAZ-AVI) has been recently introduced to combat multidrug-resistant organisms (MDROs) in the pediatric population. Case reports have documented the successful off-label use of CAZ-AVI in the treatment of MDRO sepsis in neonates; however, data remains to be limited, especially in the Philippines.

This study aims to explore the effects of CAZ-AVI on clinical outcomes including mortality rate, length of hospital stay since treatment initiation, and bacteriological eradication among patients admitted at the NICU with MDR Klebsiella hospital-acquired sepsis. Other objectives include comparing these outcomes betwee those who received CAZ-AVI (in combination with aztreonam, ATM) and those who received other 2nd line MDR-antibiotic regimens used for carbapenem-resistant Klebsiella growths, as well as exploring the association of factors such as gestational age and age at sepsis diagnosis of patients with their outcomes post-treatment with CAZ-AVI± ATM.

This is a retrospective cohort study of admitted patients in a neonatal intensive care unit of a tertiary hospital with MDR Klebsiella hospital-acquired sepsis across a two-year period. A review of medical records was done, and data were collected and analyzed.

There were a total 11 patients treated with CAZ-AVI ± ATM compared with 11 patients given other 2nd line antibiotic treatment regimens. The use of CAZ-AVI ± ATM exhibited a trend towards a decreased mortality rate (54.5%, p = 0.17), shorter length of hospital stays from treatment initiation (30.7 days, p = 0.50), and increased bacteriological eradication rates (63.6%, p < 0.05), compared with other 2nd line antibiotic treatment regimens, regardless of gestational age and age at sepsis diagnosis.

The use of CAZ-AVI ± ATM showed a more favorable trend compared with other 2nd line antimicrobials for with MDR Klebsiella hospital-acquired sepsis. These observations, however, require further confirmation with a prospective study, a longer study period, and an increase in sample size.

OBJECTIVE

Dengue remains a critical public health concern in the Philippines. Late consultation and delayed presentation of dengue patients to hospitals constantly challenge doctors. This study aimed to identify factors contributing to late consultation of dengue patients.

This analytic, cross-sectional study examined patient, parental, socioeconomic, cultural, and health system factors influencing delayed consultation among parents of patients 0 – 18 years at Batangas Medical Center and Lipa Medix Medical Center. A total of 668 parents were enrolled. Descriptive statistics and frequency tables summarized the key characteristics. Test of proportions assessed differences between groups. Univariate logistic regression screened possible predictors, followed by multiple logistic regression to identify significant factors.

Univariate analysis identified significant predictors of late consultation, including older patient age(p=0.002), residence >50 km from the hospital (p 50 km from the hospital were 2.7 times more likely to consult late (p=0.01).

Delayed consultation was influenced by the patient age, hospital type, geographic distance from the hospital, maternal marital status, and cultural beliefs in home remedies and faith healing. Strategies to improve early consultation should consider these factors.

OBJECTIVE

To determine whether neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) within the first three days of dengue illness are independent predictors of dengue severity among pediatric patients.

A cross-sectional analytical retrospective study was conducted among pediatric dengue patients admitted to The Medical City, Pasig from September 2021 to August 2024. Data collection was done through electronic chart review. Baseline characteristics were analyzed using the Kruskal-Wallis test, Chi-Square test, and Fisher’s exact test. Receiver Operating Characteristic (ROC) and Area Under the Curve (AUC) analyses, along with diagnostic performance metrics, were used to evaluate daily ratio cut-offs differentiating dengue classifications. Multivariable logistic regression was performed to assess NLR and PLR as independent predictors of warning signs or severe dengue development.

Among the 316 subjects included in the analysis, 40.5% had dengue fever without warning signs, 57.3% had dengue fever with warning signs, and 2.2% had severe dengue. Differentiating patients without warning signs from those with warning signs, the NLR cut-offs were 4.73, 2.07, and 2.5 on days 1-3, respectively, whereas from those with severe dengue, the cut-offs were 1.27, 0.68, and 0.47 on the same days. For this pairwise analysis, PLR cut-offs were 170, 233.92, and 208.79 for the first comparison; and 209.24, 244.12, and 187.5 for the second, respectively. Statistical analysis showed poor discrimination and diagnostic performance for all cut-offs. Likewise, multivariable linear regression revealed no significant correlation between either ratio and dengue severity.

NLR and PLR within the first three days of dengue illness revealed poor performance in predicting the development of warning signs or progression to severe dengue among pediatric patients.

INTRODUCTION

Respiratory infections are a leading cause of pediatric hospitalizations, particularly pneumonia. In Metro Manila, many cases lack identifiable causes, underscoring the need for advanced diagnostics. The RT-PCR Respiratory Panel 2.1 enables rapid pathogen detection, improving diagnosis and treatment. Examining demographic and clinical factors linked to severe outcomes provides valuable local insights.

This study aimed to identify and compare respiratory pathogens detected by the RT-PCR panel and determine demographic and clinical factors associated with severe outcomes in pediatric patients at a private tertiary hospital in the Philippines.

A retrospective cohort study was conducted, analyzing pediatric patients (0–18 years) admitted for respiratory infections from August 2023 to August 2024. Descriptive statistics summarized patient characteristics, while regression analyses identified factors linked to mechanical ventilation, oxygen use, and prolonged hospital stays.

Of 118 patients, 85.6% tested positive for respiratory pathogens, predominantly viral (RSV 23.7%, human rhinovirus/enterovirus 22.9%), with cases peaking in late 2023. Most patients had elevated WBC with neutrophilic redominance. Oxygen support was required in 22.9% of cases, primarily in infants under six months with RSV, who had a four-fold increased risk. Difficulty breathing was the strongest predictor of oxygen use, while the presence of neurological conditions (e.g., cerebral palsy, seizure disorders) were significantly associated with mechanical ventilation and prolonged hospital stays.

Seizure disorder, cerebral palsy, and younger age influenced severe outcomes. Pathogen specific trends in demographics, clinical findings, and oxygen support needs may help guide physicians in recognizing illnesses caused by the most common viral respiratory pathogens identified by the RT-PCR Respiratory Panel 2.1

Human ; Bacteria ; Antimicrobial Stewardship ; Insemination, Artificial, Heterologous ; Multiplex Polymerase Chain Reaction ; Polymerase Chain Reaction

The Pediatric Infectious Disease Society of the Philippines (PIDSP) Journal has been in circulation since 1996. To this day, it remains to be indexed in the Western Region Pacific Index Medicus (WPRIM), the regional bibliographic index of medical journals published by Member States of the Region. A major target for the journal this year is the planned transition to an online manuscript submission and review system. E-REVIEWS or Enhancing Research Dissemination Via An Efficient Web-based Journal Management System is underway. Preparations for wider indexing is a not too distant project. As the journal committee continues to raise the bar with its timely and relevant publications, we perceive the need for a more comprehensive Publication Ethics and Publication Malpractice Guideline based on the Code of Conduct and Best Practice Guidelines for Journal Editors of the Committee on Publication Ethics. For this reason, the Journal Team is featuring the first of a series of guidelines related to ethics in medical publication to govern all stakeholders.

Background/Objectives: The current manual processes of manuscript submission, screening, review, and editorial management in the Pediatric Infectious Disease Society of the Philippines (PIDSP) Journal rely heavily on email exchanges between the authors and journal manager, who acts as the liaison for the editors-in-chief (EIC) and peer reviewers. This method proves inefcient. To address this, the PIDSP Journal Editorial Team created E-REVIEWS, aimed at streamlining journal procedures to boost manuscript submissions, and ensure timely publication. Methodology: E-REVIEWS was developed using Python as the primary computer programming language and Django as the web framework. Gitlab served as the repository and facilitated the turnover of the software requirements from developers to PIDSP website administrators. Extensive internal testing preceded the system’s deployment to the PIDSP Journal website for real-world use. Results: E-REVIEWS yielded 11 modules, each with unique functionalities including Registration/Login, Accounts Management, Dashboard, Author Submission, EIC Initial Screening, Similarity Check, Review, Revisions, Manuscript Layout, Editorial, and Help. Deployment to the PIDSP website occurred on May 13, 2024. Two manuscripts underwent screening, review, and editorial processes seamlessly through the system. Identified bugs were promptly addressed. Conclusion The development of E-REVIEWS hopes to revolutionize research dissemination, ensuring data privacy via its user-friendly automated online manuscript submission, peer review, and editorial process.
Philippines