1.Diagnostic accuracy of the FilmArray™ Meningitis/Encephalitis panel in adult patients with suspected bacterial Meningitis in a tertiary care hospital in the Philippines
Ferron F. Ocampo ; Lina C. Laxamana
Acta Medica Philippina 2022;56(13):42-46
Objective:
Bacterial meningitis is associated with significant morbidity and mortality if not diagnosed and treated early. Isolation of the causative agent from cerebrospinal fluid culture is the gold standard for the diagnosis of this condition; however, it takes several days for results to be available. The FilmArray™ Meningitis/Encephalitis (ME) panel is a nucleic acid-based test that allows simultaneous detection of 14 bacterial, viral, and fungal pathogens in the cerebrospinal fluid with a rapid turnaround time. Our aim was to evaluate the diagnostic performance of the ME panel in detecting bacterial pathogens in the cerebrospinal fluid of adult patients with suspected bacterial meningitis in a tertiary hospital in the Philippines.
Methods:
We performed a retrospective review of hospital records of adult patients with suspected bacterial meningitis who were admitted at our institution and underwent diagnostic testing with the FilmArray™ ME panel from January 1, 2018 to July 31, 2019. Overall percent agreement, sensitivity, and specificity for individual bacterial pathogens included in the panel were determined.
Results:
A total of 88 cerebrospinal fluid samples were included in the analysis of diagnostic accuracy. The ME panel demonstrated 93.2% overall agreement, 50% sensitivity for E. coli, and 99–100% specificity in comparison with CSF culture in detecting bacterial pathogens that are included in the ME panel.
Conclusion
The results show that the FilmArray™ ME panel has high diagnostic accuracy and can be utilized in the rapid diagnosis and targeted treatment of patients with suspected bacterial meningitis.
Meningitis, Bacterial
;
Central Nervous System Infections
2.Aspirin and clopidogrel resistance in Filipino patients with recurrent noncardioembolic ischemic strokes in a tertiary hospital: A cross-sectional study
Diana-Lynn Que ; Remy Margarette Berroya-Moreno ; Christian Oliver C. Co ; Peter Paul Dela Paz Rivera ; Vincent Paul E. De Guzman ; Ma. Cristina Macrohon-Valdez ; Lina C. Laxamana ; Manuel M. Mariano ; Maria Carissa C. Pineda-Franks
Philippine Journal of Neurology 2024;27(1):20-27
Background:
Antiplatelet resistance is one factor that contributes to stroke recurrence among patients with
noncardioembolic ischemic strokes.
Objectives:
This paper aims to describe the prevalence of aspirin and clopidogrel resistance, along with
frequency of statin, NSAID and proton pump inhibitor use among our cohort of stroke patients.
Method. This is a single-center cross-sectional review that included all adult patients with
recurrent noncardioembolic ischemic stroke admitted in a tertiary hospital between January
2019 and June 2023.
Results:
A total of 1,374 patients were admitted for ischemic stroke from January 2019 to June 2023.
Among these, 155 (11.28%) were recurrent noncardioembolic ischemic strokes. Prevalence of
aspirin and clopidogrel resistance were 25% and 32.7%, respectively. Clinical profiles of those in
the resistant group were comparable with those in the nonresistant group. None of the patients
taking aspirin had concomitant use of nonsteroidal antiinflammatory drugs. Only 2 of the
patients who were resistant to clopidogrel were on proton pump inhibitors. More than half of
the patients both in the resistant and the nonresistant groups were on statin. The study had a
small sample size and hence it was not enough to establish causal relationship between factors
and antiplatelet resistance.
Conclusion
More patients were resistant to clopidogrel than to aspirin. Further studies with a bigger sample
size are recommended to explore factors that contribute to antiplatelet resistance in Filipino
patients.
Aspirin
;
Clopidogrel
;
Ischemic Stroke
;
Tertiary Care Centers