BACKGROUND

Invasive candidiasis is defined by the growth of Candida species in the bloodstream or other internal organs. It is a global concern due to increasing multidrug resistance and high mortality rates. This study aimed to update prevalence data on Candida infections in the Philippines, analyzing demographic factors (age, sex), specimen sources, and associated risk factors. We compared antifungal resistance patterns against CLSI epidemiological cutoff values (ECVs) and clinical breakpoints and examined MIC variations by underlying disease to inform potential standardized empiric therapies.

METHODOLOGY

We conducted a retrospective analytical cross-sectional study (SLMC-IERC approval, minimal risk) reviewing one year of Candida speciation and susceptibility results from January 2024 to December 2024 at a private tertiary hospital. All aseptically collected samples that tested positive for Candida species were included. Respiratory and wound specimens required a Gram stain demonstrating yeasts and hyphae prior to culture, while urine cultures were included only if they yielded ≥100,000 CFU/mL. Identification and susceptibility testing were performed using the VITEK 2 system, with results interpreted using CLSI breakpoints and ECVs.

RESULTS

Among 266 patients with Candida infections, invasive candidiasis predominated in those aged ≥60 years (66.4%). Candida albicans (21.7%) and Candida tropicalis (13.5%) were more frequent in females, while Candida parapsilosis (13.2%) and Candida glabrata (5.3%) were more common in males. Blood and CSF samples strongly correlated with invasive disease and underlying risk factors. C. albicans was linked to infection-related conditions (13.9%), malignancy (9.0%), and cardiovascular disease (6.8%). C. parapsilosis(23.3%) and C. tropicalis (20.7%) were frequently associated with infection, malignancy, and metabolic disorders. C. glabrata (7.5%), noted for antifungal resistance, was isolated in patients with direct infections (3.4%) and malignancies (1.9%). Among azoles, fluconazole demonstrated greater susceptibility against Candida species, requiring lower concentrations for inhibition, despite a higher resistance rate (13.22%) compared to voriconazole (8.95%). Among echinocandins, micafungin showed better susceptibility than caspofungin. Amphotericin B demonstrated the highest overall susceptibilit y (93 –10 0%), though MICs approached ECV limits. Most susceptible MIC values were fluconazole 0.5 μg/mL for C. albicans and C. parapsilosis, 1.0 μg/mL for C. tropicalis; voriconazole and caspofungin 0.12 μg/mL; micafungin 0.06 μg/mL; amphotericin B 0.5 μg/mL; and flucytosine

CONCLUSION

These findings support a species-specific, risk-adapted approach to antifungal therapy, incorporating demographic and clinical variables. Continuous surveillance of invasive candidiasis prevalence and antifungal MIC trends, with periodic breakpoint updates, is crucial to preserve therapeutic efficacy. Effective management of multidrug-resistant Candidainfections also requires close collaboration between clinicians and pharmacists, as well as the development of new dosing strategies based on pharmacokinetic/pharmacodynamic (PK/PD) principles.

Human ; Candidiasis ; Antifungal Agents ; Drug Resistance ; Candida ; Azoles

SARS-CoV-2 has infected more than 643 million individuals worldwide and accounts for close to 64,950 deaths in the Philippines. Due to COVID-19’s clinical overlap with other diseases and non-specific radiologic findings, its diagnosis rests primarily on laboratory methods, including reverse transcription polymerase chain reaction (RT-PCR) and multiplexed molecular platforms for rapid syndromic testing. Compared to RT-PCR which has a turnaround time of 24 to 72 hours, multiplexed molecular platforms can provide alternative diagnoses to COVID-19 in an average of one hour, providing meaningful data that can impact clinical and resource management when handling acute surge of patients with respiratory symptoms.
COVID-19 ; SARS-CoV-2

INTRODUCTION: Development of drug resistance is one of the most important barriers in achieving global control of tuberculosis (TB). Continuous surveillance, such as observation of susceptibility and resistance patterns to anti-TB drugs, together with nationwide programs aimed at TB case identification, treatment and control, physician and patient education, is a valuable tool in the goal towards reducing TB prevalence and mortality.
OBJECTIVE: It is the aim of this study to determine the prevalence rate and resistance pattern of  first line anti-tuberculosis drugs in a tertiary hospital in Manila, Philippines
MATERIALS AND METHODS: Records of specimens submitted for Mycobacterium tuberculosis (MTB) culture and sensitivity, using BACTEC TM MGIT TM 960 SIRE Kit and PZA Kit, at the Section of Clinical Pathology, University of Santo Tomas Hospital, were reviewed. Isolates cultured for MTB were subjected to sensitivity studies to rifampicin (R),isoniazid (H), ethambutol (E), pyrazinamide (Z) and streptomycin (S).
RESULTS: A total of 546 specimens were cultured for MTB and sent for sensitivity studies. Majority of the specimens were from pulmonary sources (77%). Overall resistance rate was 52.38% (n=286). One-drug resistance was 23.26% (n= 127; highest with R followed by H); two-drug resistance was 15.38% (n=84; highest with H-R); three-drug resistance was 8.61% (n=47; highest with H-R-E and H-R-S); four-drug resistance was 4.58% (n=25; highest with H-R-E-S) and five-drug resistance (H-R-E-S-Z) rate was 0.55% (n=3). 
CONCLUSION: The University of Santo Tomas Hospital, as a referral facility, is encountering an increasing number of drug-resistant tuberculosis from 2003 to 2013.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Ethambutol ; Mycobacterium Tuberculosis ; Isoniazid, Pyrazinamide, Rifampin Drug Combination ; Pyrazinamide ; Isoniazid ; Rifampin ; Streptomycin ; Pathology, Clinical ; Tuberculosis