Introduction: In the setting of Sepsis, Blood Culture is one of the important diagnostic tools in aiding a clinician to determine the offending pathogen. Following the Sepsis Bundle, Blood Culture is obtained at two sites before initiation of antibiotics. However, blood Cultures are one of the expensive tests wherein some clinicians find it unnecessary and costly. This study would provide more information regarding positive blood cultures among septic patients as a prognostic tool regarding the time to positivity. Reporting Time to Positivity would aid clinicians in the severity of the infection and could be used as a clinical predictor of mortality. This study investigated the optimal cutoff point of the time to positivity to predict mortality and the association between time to positivity of blood cultures with mortality among septic patients.

Methods: This was a single-center cross-sectional study with a retrospective chart review of septic patients with positive blood cultures. The optimal cutoff point of time to positivity was determined and associated with mortality.

Results: 405 adult in-patients with sepsis in Makati Medical Center from April 1, 2017, to April 30, 2018, were reviewed. The suggested optimal cutoff TTP is ?19.1 hours, with sensitivity 79.78%, specificity 28.48%, accuracy 39.75%, Youden's index 8.26%. The overall mortality rate is 21.98%. The mortality rate was higher in the TTP < 19.1 group at 23.91% compared to the >19.1 hours group. Predictors associated with mortality are age, liver comorbidity, genitourinary source of infection, and short TTP.

Conclusion: A short TTP was associated with higher mortality rates. TTP can be clinically used to predict poorer outcomes. Therefore, patients with a short TTP should be monitored more closely, and appropriate antibiotics should have been initiated.

Introduction: Human immunodeficiency virus infection (HIV) and Acquired Immunodeficiency Syndrome (AIDS) prevalence has been increasing for the past years in the Philippines since the early 1980s. The health care team which is comprised of doctors, nurses, pharmacists, medical technologists, and other allied health practitioners is the front liner in the care and management of such patients afflicted with the disease. Methods: This descriptive cross-sectional study assessed the knowledge, attitudes, beliefs, and practices among the health workers in Makati Medical Center. A questionnaire based on the 1988 WHO Knowledge, Attitudes, Beliefs, and Practices (KABP) of AIDS survey was used. It was sent to 307 health workers selected by cluster sampling. Results: Based on the survey, sources of information among participants regarding HIV/AIDS were quite diverse; books and journals being the most common. The majority of the participants demonstrated satisfactory levels of awareness regarding HIV/AIDS and its mode of transmission; however, a small percentage of the respondents were found to have a misconception that there is a vaccine available for HIV/AIDS and that insect bites and sharing of utensils can transmit the virus. Some of the respondents also do not know much about transmission routes and there are a few who are not willing to care for and live with patients with HIV. The majority however have a positive attitude towards people living with HIV/AIDS. Conclusion Most of the respondents of this research have good knowledge regarding the disease process and its mode of transmission. At the same time, the majority of the respondents also have a positive attitude and acceptance towards people living with HIV/AIDS. The data from the study can be used to develop interventions to decrease if not eliminate HIV stigma and discrimination. Interventions can include educating health care workers by utilizing all possible modalities to have a broader reach.
HIV ; Acquired Immunodeficiency Syndrome ; Knowledge ; Attitude ; Health Personnel

Background: With the recent rise in number of HIV/AIDS patients in the Philippines, knowledge of the most common mucosal and cutaneous findings among HIV/AIDS patients can be a valuable tool of assessment. Objectives: To determine the different mucosal and cutaneous disease findings of HIV/AIDS patients; evaluate their frequency and association with the latest CD4 cell counts, and to determine patients’ demographic and medical profiles. Methods: This is a cross-sectional study done at a tertiary hospital in Makati city from January 2017 to September 2018. Walk-in patients or those referred by Infectious Disease specialists were evaluated using a standardized history and physical examina- tion form. Latest CD4 counts were also obtained. Results: A total of 93 patients were enrolled. Majority were males (98%), with a mean age of 32 +/- 7.08, employed (64%), and on HAART (87%). A large part of the group (45%) has severe immunosuppression (CD4 counts <200/mm3). The most common manifes- tations were the following: non-infective, fungal, and drug-related dermatoses, with the most common dermatoses being seb- orrheic dermatitis, xerosis, pruritic papular eruptions (PPE), superficial fungal infections, drug hypersensitivity reactions, and syphilis. PPE was noted to be significantly associated with low CD4 counts. Conclusion Due to small population size, significant associations between the other dermatoses with their CD4 counts were not seen except for PPE, which was significantly associated with CD4 counts <200/mm3. Nevertheless, a strong suspicion for any underlying HIV//AIDS infection is still warranted in the presence of these dermatoses.
HIV ; Acquired Immunodeficiency Syndrome ; CD4 Lymphocyte Count

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) related infections are increased in patients with Diabetes Mellitus and are associated with increased morbidity and mortality. OBJECTIVES: This study aims to determine the prevalence, risk factors, and antimicrobial susceptibility patterns of MRSA nasal colonization among individuals with diabetes mellitus. METHODOLOGY: This is a prospective cross-sectional study that included adult Filipino patients with diabetes mellitus type 2. Nasal swab samples were analyzed for the presence of MRSA. RESULTS: MRSA nasal colonization has a prevalence rate of 6.8% which was associated with a history of antibiotic use. The isolates exhibited resistance to Benzypenicillin/Oxacillin (100%), Clindamycin (42.9%), Vancomycin, and Trimethoprim/Sulfamethoxazole (14.3%). CONCLUSION: The prevalence of MRSA in this population is higher compared with other Asian countries. No diabetic-related risk factors were identified to be associated with MRSA nasal colonization. The presence of resistance to most commonly used antibiotics should prompt clinicians appropriately treat infections caused by this organism.
Carrier State ; Methicillin-Resistant Staphylococcus aureus ; Nasal Mucosa ; Diabetes Mellitus, Type 2