OBJECTIVES: To determine the risk factors, clinical features, and outcomes of newborns in a tertiary care hospital who developed Acinetobacter baumannii infection.

METHODOLOGY: A retrospective case control study was performed, comparing each case of newborn infected with Acinetobacter baumannii to two uninfected controls.

RESULTS: Ninety charts were reviewed, comprising 30 cases and 60 controls. Risk factors (use of total parenteral nutrition, prior antibiotic use, presence of a central line, mechanical ventilation and intubation, blood transfusion, surgical procedure, intensive care unit admission and presence of a co-morbidity) were noted to be significantly associated with the development of A. baumannii infection (p value <0.001). A. baumannii infection manifests more commonly as fever, respiratory distress, leukocytosis, and thrombocytopenia.

CONCLUSIONS: Acinetobacter baumannii is associated with certain risk factors that increase the likelihood for its perpetuation and acquisition. The increasing number of multi-drug resistant strains of A. baumanni signifies the need to focus on certain issues as infection control and the conscientious use of antibiotics in newborns.

Human ; Male ; Female ; Infant (a Child Between 1 And 23 Months Of Age) ; Acinetobacter Baumannii ; Sepsis ; Infant, Newborn

BACKGROUND: Neonatal sepsis remains to be an important cause of neonatal morbidity and mortality and its diagnosis is difficult due to non-specific signs and symptoms that may mimic other infectious conditions. Blood culture, the gold standard in the diagnosis of sepsis, is limited by it being time-consuming and with high probability of false negative results.

OBJECTIVE: To investigate the usefulness of the NLR as a predictor in the diagnosis of neonatal sepsis and early - onset neonatal sepsis (EOS).

METHODS: Relevant publications from 2009 to 2019 that fulfilled the inclusion criteria were identified through electronic database search. Studies were analyzed and a meta- analysis was performed. The effect of NLR was calculated as a predictive factor for EOS. \

RESULTS: Four observational studies were included with a total of 392 patients. Two studies were analyzed for EOS which included 242 patients. There is significant association between NLR and neonatal sepsis. The sensitivity and specificity of NLR to predict sepsis were 84.5% and 91%. The sensitivity and specificity of NLR to predict EOS were 71% and 66%.

CONCLUSION: NLR is an acceptable tool in predicting neonatal sepsis and EOS but its usefulness is limited due to the presence of bias and heterogeneity in the studies included.

RECOMMENDATIONS: Further studies, preferably local studies, to investigate and validate the usefulness of the NLR as a predictor of neonatal sepsis and EOS is recommended.

Human ; Male ; Female ; Infant (a Child Between 1 And 23 Months Of Age) ; Neonatal Sepsis ; Meta-analysis

OBJECTIVE: To compare actual tracheostomy tube sizes with estimated endotracheal tube sizes using age-related formula and tracheal diameter from preoperative radiographs among pediatric Filipino patients aged 0-18 years old undergoing tracheostomy.

METHODS:

          DESIGN: Review of records

          SETTING:           Tertiary Private University Hospital in Dasmarinas, Cavite, Philippines

          PATIENTS:         Pediatric patients regardless of gender, aged 0 to 18 years old, with a preoperative radiograph of the trachea, and who subsequently underwent tracheostomy anytime from January 1, 2007 to                December 31, 2016 were considered for inclusion. Radiographs were measured, endotracheal tube sizes were computed using age-related formula, and recorded tracheotomy tube sizes were retrieved.

RESULTS: Twenty-two patients (12 males, 10 females) aged 10 months to 18-years-old (median age: 11 years) were included in the study. Mean tube sizes were 6.46mm (+/- 1.492 SD) for age-related formula, 5.67mm (+/- 1.1849 SD) for radiograph-based estimation, and 5.0 for actual tracheostomy tube inserted in each patient. The Bland-Altman plot showed the bias estimate at 0.7913 and the lower and upper limits of agreement at -1.3598 and 2.9423 (confidence level 95% or 2 standard deviations away from the mean).

CONCLUSION: The average value derived from radiograph-based estimation is less than the corresponding average value from age-related formula. There is a significant difference between age-related formula-based estimation and actual tracheostomy tube inserted. Since the range of differences between the two estimation methods is high, these results imply that the bias or the difference between measures from the two methods is not consistent, with the two methods exhibiting very poor agreement.

 

 

Human ; Male ; Female ; Adolescent (a Person 13-18 Years Of Age) ; Infant (a Child Between 1 And 23 Months Of Age) ; Tracheostomy ; Intubation

Objective: To report a case of isolated ankyloglossia superior in a one-month-old boy.

Methods:

Design: Case Report

Setting: Tertiary Government Training Hospital 

Patient: One

Results: A one-month-old boy with failure to thrive, feeding difficulties and a palatoglossal band that limited mouth opening and anterior posturing of the tongue was diagnosed to have non-syndromic ankyloglossia superior and underwent surgical transection of the fibrous ankylosis under intravenous sedation due to difficulty of insinuating an endotracheal tube orally. Direct latch breastfeeding was successfully adapted from the second to tenth postoperative day before they were lost to follow up.

Conclusion: Despite a complicated pediatric airway, coordinated surgical and anesthesia management successfully restored tongue function and mouth opening to allow effective feeding.

Human ; Male ; Infant (a Child Between 1 And 23 Months Of Age) ; Ankyloglossia Superior ; Tongue-palate Fusion ; Palatoglossal Ankylosis ; Oral Synechiae

BACKGROUND AND OBJECTIVE: Kawasaki Disease (KD) is the leading cause of acquired heart disease in children in developed countries. We aimed to determine the predictors of intravenous immunoglobulin (IVIG) resistance based on clinical manifestations and laboratory parameters.

METHODOLOGY: This was a retrospective cohort study of classic KD patients.    

RESULTS: Two hundred and ten patients were included in the study. The mean age was 2.0 ±1.8 years old with slight female predominance at 51.4%. Seven (3.3%) cases were found to be IVIG resistant. There was no significant difference in age, clinical manifestations or fever duration.  Univariate analysis revealed that IVIG resistant group had a heavier weight with mean of 16.4 kg ± 12.2 compared to the IVIG responder group 12.2kg ± 4.8. The IVIG resistant group had a higher white blood cell count of 23.9 ± 7.8 compared to the responder group of 17.9 ± 6.5.                           

CONCLUSION AND RECOMMENDATIONS: There is an IVIG resistance rate of 3.3% among classic KD patients. A high white blood cell count and weight are probable predictors for IVIG resistant KD. We recommend a larger sample size of resistant cases and a case-control multicenter study.

Human ; Male ; Female ; Child Preschool (a Child Between The Ages Of 2 And 5) ; Infant (a Child Between 1 And 23 Months Of Age) ; Mucocutaneous Lymph Node Syndrome ; Immunoglobulins ; Retrospective Studies ; Child