1.Utility of Urine KOH in Detecting Candiduria in Infants
Mark Joseph S. Castellano ; Mary Antonette C. Madrid
Pediatric Infectious Disease Society of the Philippines Journal 2020;21(1):7-15
Background:
Candida species are common cause of urinary tract infection in infants requiring medical care. Candida fungal elements may be demonstrated in urine using microscopic examination with potassium hydroxide (KOH). However, detection of these elements does not always correlate with candiduria.
Objectives:
To establish the utility of urine KOH in identifying candiduria and to determine the risk factors, as well as urinalysis and CBC parameters associated with candiduria.
Methods:
This prospective cross-sectional study included admitted infants 1 year and below with urine culture and with any risk factor/s for candiduria. Additional urine KOH testing was done using clean catch or catheter method. Urine culture was used as the gold standard.
Results:
Among the 90 study participants with both urine culture and urine KOH, 13 (14%) had candiduria. The use of indwelling catheter, presence of urinary tract anomalies, positive leukocyte esterase in urinalysis, and increased monocyte counts in CBC are all associated with candiduria. Urine KOH has sensitivity of 100%, (CI 75.2-100%), specificity 59.7%, (CI 47.9-70.7%), PPV 29.5%, (CI 17.7-45.2%), and NPV 100%, (CI 92.2-100%) in detecting candiduria.
Conclusions
Negative urine KOH has excellent negative predictive value, while positive urine KOH result may warrant further investigation. Urine KOH results should be interpreted with caution depending on patient’s risk factors, clinical status, and other laboratory results prior to initiation of empiric antifungal therapy. Positive urine KOH may not always require treatment.
Candida
2.2021 clinical practice guidelines in the evaluation and management of pediatric community-acquired pneumonia
Ma. Victoria S. Jalandoni-Cabahug, M.D. ; Maria Rosario Z. Capeding, M.D. ; Kristine Alvarado-Dela Cruz, M.D. ; Mark Joseph S. Castellano, M.D. ; Maria Nerissa A. De Leon, M.D. ; Jay Ron O. Padua, M.D. ; et al.
Pediatric Infectious Disease Society of the Philippines Journal 2023;24(1):121-175
Preface
The Clinical Practice Guidelines (CPG) for the Diagnosis and Management of Pediatric Community-Acquired Pneumonia (PCAP) was
initiated by the Philippine Academy of Pediatric Pulmonologists, Inc. (PAPP) and the Pediatric Infectious Disease Society of the
Philippines (PIDSP), in cooperation with Philippine Pediatric Society, Inc. (PPS) way back in 2004. Several CPG updates were then
undertaken by the PAPP PCAP CPG Task Force from 2008 to 2016. Clinically-relevant research questions were answered with recent
and current recommendations based on evidence from local and international data.
The 2021 PCAP CPG initiative was envisioned in March 2018 upon the recommendations of the 2018 PAPP Board for the purpose of
updating the evidence in the PCAP CPG 2016 clinical questions. This led to the collaboration of PAPP and PIDSP to develop this CPG.
Individual members were identified from each society as content experts to form the Steering Committee along with a clinical
epidemiologist and technical writer as review experts. The committee identified the scope and target end user of the CPG as well as
additional clinical questions to be included in the 2021 update aside from the questions on the previous CPGs. Selected members from
the two societies formed the Technical Working Group (TWG) who did the literature search, appraisal of evidences, and formulation
of recommendations. These recommendations were then presented to the stakeholders who became part of the consensus panel.
There was no identified conflict of interest among the CPG developers, TWG members and stakeholders. A survey to determine
potential competing interests were conducted during the development of this CPG. This initiative was fully funded by the PAPP and
PIDSP societies.
The 2021 PCAP CPG significantly differs from the previous CPGs in several aspects. First, the current guideline is a consensus between
two pediatric societies. Second, much of the literature review has been centered on meta-analyses or systematic reviews instead of
individual studies. Finally, appraisal of published literature was based on Grading of Recommendations, Assessment, Development
and Evaluation (GRADE) criteria. Such methodological differences may provide difficulties in defining evolution of care through the
years.
As identified in the previous CPG updates, there is lack of local data hence most of the evidences gathered came from international
studies. The applicability of such data to the local setting needs to be critically assessed for its value and relevance. Corollary to this,
several gaps in knowledge are identified and these may serve as a guide for future research.
3.Demographics, injury patterns, and management profile of animal bite cases in a national infectious disease and research facility.
Mark Joseph CASTELLANO ; Johanna Beulah SORNILLO ; Nobuo SAITO ; Akira NISHIZONO ; Beatriz QUIAMBAO
Pediatric Infectious Disease Society of the Philippines Journal 2025;26(1):3-11
BACKGROUND
Rabies remains to be a neglected tropical disease in the Philippines, with the country reporting a higher number of cases compared to its counterparts in Asia.
OBJECTIVETo describe the demographics, animal bite characteristics, and post-exposure prophylaxis of animal bite patients coming in for care at the Research Institute for Tropical Medicine (RITM), a large government referral center for infectious diseases, and animal bites.
METHODSElectronic patient records from January 1, 2018 to December 31, 2019 were obtained from the National Rabies Information System (NaRIS) database of the Department of Health, and summarized using applicable descriptive statistics.
RESULTSA total of 14,614 patients were included over the two-year study period, and more than third of the patients were children below 15 years old, while more than half were adult males. Lower extremities were the most frequently affected area, while with children, more than a third of exposures were in the head and neck areas. Intradermal route was mostly used for the post-exposure prophylaxis, while WHO prequalified vaccines were utilized in more than 90% of the patients. Only 55.7% of patients completed the prophylaxis regimen at RITM.
CONCLUSIONThese findings reflect the significant exposure of children from animal bites, and the non-compliance of patients to the prescribed post-exposure prophylaxis.
Human ; Animals ; Rabies ; Post-exposure Prophylaxis ; Rabies Vaccines