Objective: The objective of this study is to determine the prevalence and the most common causative agent of urinary tract infection (UTI) in pregnant women having prenatal check-up at a tertiary hospital, as well as the antibiotic sensitivity of these organisms to selected antimicrobials that are currently recommended for use in the treatment of UTI in pregnancy (specifically Nitrofurantoin, Amoxicillin, Cephalexin, Cefuroxime, Amoxicillin with Clavulanic acid). The results of this study will not only update the hospital’s biogram, it will also aid the physicians in prescribing patients with the most cost-effective regimen. Methodology: Patients seen at the outpatient department were included in the study starting May 2017 up to September 2017. Patients with previous antibiotic intake during the current pregnancy were excluded. A questionnaire containing demographic data, prenatal history, checklist for symptoms, and consent were provided for each patient. As per guidelines, urine gram stain and culture studies were requested during their prenatal visit. All urine specimen were sent to the same laboratory for microscopy and culture. Results were analyzed using SPSS v 23.0 Result: The prevalence of urinary tract infection in pregnant patients having prenatal care at a tertiary hospital in Manila was 15.6%. The most common isolates were still E. coli and Staphylococcus. Symptoms were not reflective of the presence of UTI and previous prenatal care did not affect the presence UTI. Analysis of sensitivity and resistance patterns of the isolated organisms showed increasing resistance to the commonly used antibiotics given to pregnant patients, especially Co-Amoxiclav. Cephalosporins, on the other hand, remain to have good sensitivity. Conclusion Urinary tract infection is prevalent among pregnant women having prenatal check up at a tertiary hospital. It is recommended that guidelines on the diagnosis of UTI in pregnancy be strictly followed so that management will be culture-guided, thus preventing the development of antibiotic resistance.
Urinary Tract Infections

Introduction: Although it is likely that outcomes in pregnancy differ between regions due to differences in health‑care delivery, resources, and health protocols, the rampant increase in COVID‑19 cases has proven its effects on the maternal and fetal outcomes. But to what extent does COVID‑19 in pregnancy affect adverse maternal and neonatal outcomes compared to non‑COVID‑19 pregnant patients? Objectives: This study aims to compare maternal outcomes (morbidity, mortality, intensive care unit [ICU] admissions, and cesarean section [CS] rate) and fetal outcomes (prematurity, APGAR score, neonatal ICU [NICU] admission, and mortality) between COVID‑19 and non‑COVID‑19 cases. Methodology: A retrospective cohort study was done through chart review of 240 patients, 120 for the COVID‑19 group and 120 for the non‑COVID‑19 group. Demographic data, as well as maternal outcomes (i.e., morbidity, mortality, ICU admissions, and emergency CS), and adverse fetal outcomes (i.e., prematurity, low APGAR, NICU admission, and mortality) were gathered. These outcomes were also classified according to disease severity for the COVID‑19 group. The effect of using investigational drugs to outcomes was also determined. Results: This study shows that adverse maternal outcomes were significantly increased with COVID‑19 infection. Mortality was increased by 10% while morbidities (acute respiratory distress syndrome, disseminated intravascular coagulation, hemorrhage, and sepsis) were increased by 35%. ICU admission for COVID‑19 patients was 10.8% higher, and the emergency CS rate was also increased by 10% in the COVID‑19 group. Results also showed increased adverse fetal outcomes for the COVID‑19 group, with a 10.8% increase in neonates being born prematurely, an 11.67% increase in low APGAR score, a 9.16% increase in mortality, and a 10% increase in NICU admission. The use of investigational drugs in cases of severe and critical COVID‑19 did not have any significant benefits to the outcomes. Conclusion COVID‑19 infection significantly increases both maternal and fetal outcomes, and these adverse effects correspond to the severity of the disease. The use of investigational drugs in severe and critical COVID‑19 cases has no significant benefit to maternal and fetal outcomes.

BACKGROUND AND OBJECTIVE

Tuberculosis (TB) remains to be prevalent in the Philippines and globally. Female genital tuberculosis has devastating and permanent consequences, hence, timely and adequate treatment is needed. Since more data regarding optimal duration of treatment of genital tuberculosis are needed, this study compares the treatment response at six months and after at least nine months of treatment, with the intention of determining the most practical management for genital tuberculosis.

METHODS

A retrospective chart review was conducted for newly diagnosed cases of genital tuberculosis who met the inclusion criteria. Treatment response was categorized into clinical, microbiologic, histologic, radiologic, and sonographic responses. Responses to treatment were evaluated as either partial or complete at the 6th month and after at least 9 months of treatment, and the proportions were compared.

RESULTS

Out of 140 charts retrieved, only 43 were included. Statistically significant difference was found only in clinical response, primarily due to patients who did not achieve resumption of menstruation within the f irst six months of treatment. The rest of the treatment responses and adverse drug events are equally the same for both time periods.

CONCLUSION

Results of this study show that the proportion of patients with microbiologic, histologic, radiologic, and sonographic response to treatment at the 6th month did not significantly differ to the proportion of patients who responded at the 9th or 12th month of treatment. This leads to a conclusion that the 6-month treatment regimen will be more practical in treating genital tuberculosis, except in amenorrheic premenopausal women who may warrant extension of treatment. Further studies on post-treatment rates of relapse and sonographic resolution are needed.

Human ; Female ; Tuberculosis, Female Genital ; Philippines

OBJECTIVE: The study aimed to determine the basic histomorphologic effects of Bacillus clausii (B. clausii) spores in enteropathogenic Escherichia coli (E. coli) O127:H21-infected mice by evaluating the spleen, mesenteric lymph nodes, and intestinal mucosa.

METHODS: The study involved 46 apparently healthy Balb/c mice (Mus musculus) which were acclimatized for 19 days prior to any intervention. Sixteen mice were used to determine the sublethal dose of E. coli, which was performed by administering serially-diluted solutions and subsequent generation of a standard curve. From the remaining 30 mice, ten served as normal controls while the remaining 20 were randomized to receive either B. clausii or placebo of sterile water for a week. All mice were then challenged with E. coli for another week and euthanized, and the spleen, mesenteric lymph nodes, and small intestine harvested and examined microscopically. All study personnel were blinded of the treatment assignments.

RESULTS: Histologic evaluation of the small intestine in E. coli only-fed mice exhibited prominent attachment effacement lesions, with severely denuded mucosa, lymphocytic infiltration, and debris in the intestinal lumen. However, mice given B. clausii prior to E. coli infection displayed only minimal mucosal damage with less sloughing of villus tips, plus increased mucus-secreting goblet cells. In the spleen, E. coli only-fed mice showed moderate to severe lymphoid hyperplasia with blurred boundaries between red and white pulp. In contrast, mice which received B. clausii prior to E. coli infection had only mild degrees of lymphoid hyperplasia. Similar findings were seen in the mesenteric lymph nodes where E. coli only-fed mice showed moderate to severe lymphoid hyperplasia while those given B. clausii prior to E. coli infection merely had mild lymphoid hyperplasia.

CONCLUSION: B. clausii exerts a potential protective and immunomodulatory action in E. coli O127:H21-infected mice based on histomorphologic effects. However, additional studies are needed to fully characterize these mechanisms.mice based on histomorphologic effects. 

Animal ; Enteropathogenic Escherichia Coli ; Goblet Cells ; Mice, Inbred Balb C ; Spleen ; Bacillus Clausii ; Hyperplasia ; Escherichia Coli Infections ; Intestinal Mucosa ; Lymph Nodes