The editorship came in as a big, BIG surprise. This with a bang and the news that our dear EIC (over the last 15 years), Dr. Cecilia Maramba-Lazarte will relinquish her post. The whole gamut of human emotions came into play as if I were this character Riley from “Inside Out”(Disney). I felt overly surprised. There was sadness, disgust, even fear. Anger? Angst? There was no perfect word to describe what it felt to be tasked to carry on and bring further “THE PIDSP JOURNAL”.

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: Acute cholangitis (AC) in children is a rare but life-threatening infection. Symptoms vary from mild to severe disease. There are no local published data on pediatric AC. Objective: To determine the clinical, biochemical, ultrasonographic, microbiologic features, and treatment outcome of pediatric patients with definite AC. Methodology: Cross-sectional study using medical records of pediatric patients diagnosed with definite AC based on the Modified Tokyo Guidelines of 2018 admitted from January 2016 to June 2021. Results: Twenty-seven patients aged 0 to 18 years old (10.06 + 7.34), predominantly male (51.85%) were included. Choledocholithiasis (22%) and post-Kasai biliary atresia (22%) were the common underlying biliary conditions. Fever (88.89%) was the most frequent presenting symptom. Majority were classified as moderate AC (40.74%). Leukocytosis (mean 16×109/L), elevated inflammatory markers (93.33% with CRP >12mg/L and 100% with serum procalcitonin >0.25ng/mL), hyperbilirubinemia (total bilirubin 192.54±126.87umol/L) and elevated alanine transferases (mean 59 IU/L) were noted. Twenty-one out of 27 cases (87%) had a negative blood culture. Only 4 patients underwent bile culture, of which two (50%) grew Klebsiella pneumoniae resistant to empiric antibiotics. Dilated biliary ducts were observed on abdominal ultrasound in 92.59% of patients. Ampicillin-sulbactam (29.63%) was the most commonly utilized antibiotic. Discharge rate was high (88.89%). Conclusions AC affects all pediatric age groups but clinical presentations vary. Drug resistant organisms are a significant concern but despite this, favorable outcomes have been documented.
Cholangitis ; Child ; Choledocholithiasis

Background: Osteomyelitis is a debilitating disease if not properly treated. Epidemiologic and microbiologic data will be of great importance in the direction of treatment. Objective: To determine the epidemiologic and clinical profile of pediatric patients with chronic osteomyelitis admitted at Philippine General Hospital from 2006 to 2010. Methodology: This is a retrospective study involving a review of medical records of pediatric patients with chronic osteomyelitis admitted at the Philippine General Hospital during the 5 year study period. Frequencies and percentages were computed for nominal data. Comparison of the different variables was done using Chisquare and Fisher Exact test. Results: Eighty of the 134 cases of pediatric patients with chronic osteomyelitis were reviewed. Twenty-three percent of all operations involved the femur (N=18) and tibia (N=18). On radiograph, the presence of sequestrum was the most common finding noted in 53% of the cases. The predominant organism isolated in bone cultures was MSSA (40%) followed by MRSA (20%). On tissue cultures MRSA was the most common isolate in 34%, followed by MSSA(31%). Majority of the patients were given Oxacillin as empiric therapy (55%).No significant difference was observed with respect to the areas of bone involvement, signs and symptoms, radiologic findings and laboratory parameters between MSSA and MRSA osteomyelitis (p>0.05). Conclusion There were 239 per 100,000 cases of chronic osteomyelitis. The most common bones involved were the femur and tibia with sequestrum as the most common radiologic finding. In the previous studies, MRSA was not reported but was noted in the present study. Most of the patients in our study were treated with both antibiotics and surgery to optimize management. Ninety-eight percent of the cases had significant clinical improvement upon discharge. Based on this study, laboratory parameters, clinical manifestations and area involved cannot be utilized in differentiating MRSA from MSSA osteomyelitis. Further studies are needed to support our findings and isolation of the organism is still required for definitive identification to distinguish between MRSA from MSSA osteomyelitis.
Staphylococcus aureus ; Methicillin-Resistant Staphylococcus aureus