Acute gastroenteritis is considered as one of the most common causes of morbidity and mortality worldwide. In the Philippines, the World Health Organization (WHO) noted that acute gastroenteritis is the most common cause of morbidity and it ranks among the top 20 causes of mortality. The standard treatment as provided by WHO is the use of oral rehydration solution, intravenous fluid if indicated, and zinc supplement. Recently, the use of probiotics has been introduced as an adjunct to the treatment of acute gastroenteritis; however, its role in the management of the disease has not yet been fully established. Objective: This study aims to determine the clinical efficacy of multi-strain probiotics (Protexin) as adjunct treatment of acute gastroenteritis. Methodology: This is a randomized, single-blinded, clinical trial of patients with acute gastroenteritis from age two months to two years old and who were assigned to either Standard Treatment only (Control Group) and Standard treatment plus Protexin (Protexin Group). Both study groups were treated in accordance to the WHO standard regimen of treatment for diarrheal diseases with the addition of a Protexin given to Group B. The frequency of purging, character or texture of stool, length of hospital stay, and adverse reaction to the drug were noted. Results: A total of 51 patients were eligible for the study. No untoward event was noted from both groups and no adverse reaction was observed when Protexin was used during the study. The Protexin group had a significant decline in purging rate -as early as the second day -which is almost half the purging rate in the control group. Although both groups showed improvement in stool consistency, the experimental group showed significant improvement on the second hospital day. The experimental group had a significantly shorter course of hospitalization of at least one day. The analysis of variance showed a significant difference between the two study groups regarding purging rate, stool consistency, and duration of hospital stay. Conclusion: Protexin is both efficacious and safe in patients 2 months to 2 years old with acute gastroenteritis. Thus Protexin is beneficial and provides an additional therapeutic modality in the treatment of acute gastroenteritis.
Human ; Male ; Female ; Child Preschool ; Infant ; PROBIOTICS ; GASTROENTERITIS ; TREATMENT OUTCOME

Background: Environmental surfaces harbor pathogens that transmit them and there is a need for environmental cleaning and disinfection to prevent the spread of infection. Objective: This study aimed to determine if the use of fluorescent marking (FM) technique in high touch areas can be used as an index of cleanliness and disinfection as determined by aerobic colony count. Methods: This was an experimental study done at the University of the Philippines Philippine General Hospital Neonatal Intensive Care Unit (NICU). A total of 40 surfaces were swabbed for cultures with aerobic colony count (ACC) then adjacent areas are marked with fluorescent gel. After cleaning and disinfection, checking for residual fluorescent markings with congruent environmental culture with an aerobic colony count of the same surface was done. The rate of removal and colony count were then compared to assess the specificity and sensitivity of the fluorescent marking technique as a gauge of cleanliness of high touch surface areas. Any residual fluorescence of the marked areas was considered unclean and an aerobic colony count of < 2.5 – 5CFU/ml 2 were considered an acceptable level of cleanliness. Result: A total of 40 high contact surfaces were sampled from 5 areas were collected. Prior to cleaning, 60% (24) of the surfaces (60%) did not contain microorganisms. After cleaning, the (FM) had 38% and in the ACC 83% were assessed to be clean. The sensitivity of FM is 85.71% and specificity of 42.42%. The positive predictive value (PPV) is 24% with the positive likelihood ratio (positive LR) of 1.49 and the negative predictive value (NPP) is 93.33%. Conclusion The use of Fluorescent Marking technique in high touch areas as an index of cleanliness and disinfection is a good marker for cleanliness and disinfection. Furthermore, it is a simple, rapid, inexpensive and has potential to increase awareness of the environment that can be utilized as an objective parameter to assess cleanliness and disinfection.
Cross Infection

Background: Neonatal sepsis contributes to significant morbidity and mortality. Blood culture, the gold standard in its diagnosis, has low sensitivity and is affected by multiple factors. Hence the need for markers derived from routine tests to improve diagnosis deserves further studies. Objectives: This study aims to determine the association and optimal cut-off value and diagnostic performance of absolute neutrophil count (ANC) and neutrophil lymphocyte ratio (NLR) with early-onset neonatal sepsis in term neonates. Methodology: This was a retrospective, analytical, single-center study of admitted patients from January 2016 to December 2021. Clinical factors were analyzed and NLR and ANC were derived from CBC and interpreted using the Manroe chart. Results: Included were 200 neonates with a median birth AOG of 38 weeks. Microorganisms were isolated from nine of 154 neonates with blood culture, corresponding prevalence of 5.84% (95% CI 2.71–10.80). Initial CBC showed elevated mean WBC and 76.5% of neonates were considered to have elevated ANC. Optimal cut-off point of NLR for detecting culture-proven sepsis was 2.86, with a sensitivity of 88.89% (95% CI, 51.75–99.72%) and specificity of 36.55% (95% CI, 28.72–44.95%). The ANC gave the best balance of sensitivity and specificity with an accuracy of 75.50%. Conclusions The NLR demonstrated good discriminative ability for predicting clinical neonatal sepsis based on ANC. However, individually or simultaneously, these markers demonstrated poor discriminative ability for culture-proven neonatal sepsis in term neonates. ANC and NLR can be used to aid in the diagnosis of clinical neonatal sepsis.
Neonatal Sepsis