The introduction of antibiotics has revolutionized the control of infections that remarkably reduced morbidity and mortality worldwide. Antibiotics have been the mainstay of treatment for many bacterial infections since their introduction in the 1940s. Through the years, the number and variety of antibiotics have increased due to the emergence of different bacterial infections. The challenge of antibiotic resistance is global. Many studies have been published showing the gravity of this problem both in the hospital and community setting. An important aspect of antimicrobial resistance (AMR) greatly affecting the medical community are the extended-spectrum beta-lactamase- producing organisms (ESBL).

OBJECTIVE: The study aims to determine the prevalence, antibiogram, and genotypic characteristics of the different isolates of ESBL in the Philippines.

METHODS: Available literature on ESBL in the Philippines from PUBMED and Herdin was collected, and additional microbiological data was gathered from the Philippine General Hospital (PGH). Ten studies and three annual ARSP reports of the 22 sentinel sites were included. The bacterial isolates and sensitivity to extended-spectrum antibiotics were collated and compared with each other.

RESULTS: There is increasing prevalence of ESBL from 1999-2013. The proportion of ESBL K. pneumoniae and E.coli ranged from 10 - 43.24% and 4 - 20.9%, respectively. There was varying antimicrobial activity against antibiotics. Limited data on the genotypic characteristics of ESBL was reported.

CONCLUSION: The continued rise in ESBL resistance needs immediate action. Information on ESBLs is limited, particularly in the country. More studies need to be conducted to expand our knowledge of ESBLs.

.escherichia Coli ; Anti-bacterial Agents ; Prevalence ; Hospitals, General ; Philippines ; Anti-infective Agents ; Drug Resistance, Bacterial ; Klebsiella Pneumoniae ; Microbial Sensitivity Tests ; Bacterial Infections ; Beta-lactamases ; Pubmed ; Gravitation

COVID-19 has disrupted daily living globally due to increased deaths and lockdowns that heavily affected 156 million learners as of July 2021. Over 28 million Filipino students had their classes cancelled for more than 41 weeks; hence, educational institutions have endeavored to continue teaching via alternative learning modes with remote learning as the most feasible. However, literature has mixed views of online education, citing positive and negative factors affecting learning. Thus, the objective of the article is to synthesize existing literature on the potential factors influencing student learning during the COVID-19 pandemic. Curricular design should take note of both physical and human factors. Physical factors include internet access and EdTech, while human factors include instructor's characteristics, curricular design, and student characteristics, attitudes, and psychosocial needs. Various steps such as ensuring internet access, training teachers, and characterizing students, alongside continuous feedback and timely preparation, are recommended to properly execute remote learning in emergencies.
Learning ; COVID-19

Background: In the time of the COVID-19 pandemic, the use of personal protective equipment (PPE) as an infection control measure is recommended for healthcare settings to prevent the spread of the virus. However, given the increased demand for PPEs worldwide and the limited resources available in the country, supply shortages are experienced by many healthcare facilities and workers. Furthermore, most PPEs should be discarded after use and may only be reused under emergency situations. Thus, the study sought to determine how to maximize PPE usage. Objective: The study aimed to compare the effect of Ultraviolet Germicidal Irradiation (UVGI) against Bacillus subtilis between 30 and 40-minute periods. Specifically, the study targetted to establish if there is a difference in the mean percent reduction in CFUs of B. subtilis between that of the 40-minute and 30-minute treatment group of N95 FFRs and coverall suits. Methodology: The study is a secondary research which builds upon the experimental results of the commissioned study conducted by the Department of Medical Microbiology (DMM), College of Public Health, University of the Philippines Manila researchers to conduct data analysis. Furthermore, the PPE evaluated were coverall suits and N95 filtering facepiece respirators. They inoculated a total of 30 samples with B. subtilis for each type of PPE and subjected them to UVGI treatment in 30 and 40-minute periods. This study then employed inferential statistics, particularly a two-sample independent t-test, to further analyze the data from DMM and assess the difference between the two UVGI exposure durations on PPE decontamination. Results: After calculating and analyzing the data using OpenEpi, the mean percent reduction was statistically greater (p-value = <0.0000001, α = 0.05) in the 40-minute exposure than the 30-minute exposure. The mean percent reductions of the N95 respirators were 98.68% and 99.41% for the 30 and 40-minute exposures, respectively. On the other hand, the mean percent reductions of the coverall suits were 80.40% and 99.71% for the 30 and 40-minute exposures. Conclusion Based on the significant difference in bacterial reduction between the two time exposures, the longer UVGI time exposure was more effective as a disinfectant. The results of the study contributed to knowledge on infection control using UVGI and its possibility as a method of decontaminating PPEs.
N95 Respirators

Background: Salmonellosis is one of the most reported bacterial foodborne illnesses worldwide. Salmonella outbreaks are also prevalent in the Philippines, with egg-containing food and feces of chicken as implicated sources. The presence of Salmonella in eggshells and in egg content poses a significant threat to public health. Hence, this study aimed to determine the presence of S. enterica from different parts of chicken eggs sold in a public market in the City of Manila. Methodology: A descriptive study design was employed to detect the presence of Salmonella spp. in different parts of retail chicken eggs. A total of 72 egg samples from 24 stalls were included. The methodology for isolation and identification of Salmonella followed the guidelines set by the US Food and Drug Administration as seen in the Bacteriological Analytical Manual with some additions and modifications. Results: Contaminated eggs were found in 21 (87%) of the 24 stalls. A total of 29 (40%) out of 72 eggs were identified as the source of putative Salmonella isolates. Nineteen (66%) eggs had putative Salmonella isolates from the eggshell, while 7 (24%) had putative Salmonella isolates from the egg content. There were three (10%) eggs with both eggshell and egg content possibly contaminated with Salmonella. Conclusion The presence of putative Salmonella and Enterobacteriaceae highlight the need to strengthen food safety at the production and distribution levels of retail chicken eggs. There is also a need to establish a national surveillance system along with strengthened diagnostic capacity for S. enterica in the Philippines.
Salmonella

Background: Coronavirus disease 2019 (COVID-19) is a respiratory disease that causes remarkable morbidities and mortalities worldwide. Public health measures have been implemented to control the spread of the disease. Knowledge, attitudes, and practices (KAP) of the community have to be optimum for the successful implementation of the prevention and control measures. Objective: Cognizant that children may possibly contribute to community transmission and that primary caregivers are the main educators of their children and implementers of preventive measures at the household level, the study aimed to determine the KAP of primary caregivers towards COVID-19 in a private tertiary hospital in Metro Manila, Philippines. Methodology: The study utilized a descriptive, cross-sectional design employing a web-based self-administered survey to determine the KAP of primary caregivers towards COVID-19 in a tertiary hospital. Results: There were a total of 149 respondents. Participants had a generally high knowledge of COVID-19, its symptomatology, and its prevention. Most of the respondents agreed that vaccination, quarantine, and community quarantine are necessary to prevent transmission. Primary caregivers responded that they protected their children by avoiding exposure and observing good hygiene measures. Despite the ongoing pandemic, most respondents would still bring their children to the doctor for routine vaccinations and consultations at the hospital when sick. Conclusion The findings of the study revealed a generally good KAP among the primary caregivers of pediatric patients which can help ensure the prevention and control of COVID-19. A strong health education campaign is needed to provide accurate information that will help sustain and/or increase compliance with COVID-19 prevention and control measures.
COVID-19 ; Knowledge ; Attitude

Background and Objective: Antimicrobial resistance (AMR) is a leading global public health concern as it resulted in more difficult-to-treat infections and fatalities. In the Philippines, drug-resistant E. coli, including multidrug-resistant (MDR), extended-spectrum beta-lactamase (ESBL)-producing, carbapenemase-producing carbapenem-resistant (CP-CR) E. coli, have been isolated from common food animals, increasing the risk of cross-contamination between humans, animals, and the environment. However, there is a lack of data on the distribution of E. coli in chicken meat in public wet markets. This study aims to describe the AMR profile of E. coli in raw chicken meat from retail stalls in a selected wet market in Manila City. Methods: This quantitative descriptive study characterized the AMR profile of E. coli isolated from 25 raw chicken meat samples from a wet market in Manila City. Antimicrobial susceptibility was determined through disk diffusion method against 23 antimicrobial agents in 16 antimicrobial classes. MDR E. coli were identified based on the resistance patterns. ESBL- and carbapenemase-producing capacities of the bacteria were tested through double disk synergy test and modified carbapenem inactivation method, respectively. Results: Twenty-four out of 25 (96%) chicken samples contained E. coli isolates. Of these, 23 (96%) were classified as MDR. High resistance rates were observed against ampicillin (92%), tetracycline (88%), trimethoprim-sulfamethoxazole (83%), chloramphenicol (79%), ampicillin-sulbactam (75%), amoxicillin-clavulanic acid (67%), fosfomycin (67%), and streptomycin (54%). The majority of the E. coli isolates were still susceptible to a wide range of selected antimicrobial agents, including carbapenems (100%), ceftriaxone (100%), cefepime (100%), cefuroxime (96%), cefotaxime (96%), ceftazidime (96%), piperacillin-tazobactam (96%), aztreonam (96%), cefoxitin (92%), and nitrofurantoin (83%), among others. Meanwhile, none of the 24 isolated E. coli samples were classified as ESBL- and CP-CR E. coli. Conclusion Among the 25 chicken samples, 24 E. coli colonies were isolated that exhibited 0% to 92% resistance rates against selected antimicrobial agents. Most isolates were classified as MDR, but none were considered ESBLand CP-CR E. coli. This study suggests that chickens in wet markets can potentially serve as reservoir hosts for drugresistance genes, which could transfer to other bacteria and contaminate humans, animals, and the environment within the food production and supply chain. These findings emphasize the need for AMR surveillance and strategies to combat AMR in the Philippines through the One Health approach.
drug resistance ; multi-drug resistance ; drug resistance, multiple ; carbapenemase ; Escherichia coli

COVID-19