Pub Date : 2023-11-23DOI: 10.56964/pidspj20232402002
Ray Mendoza, Belle Ranile, Nathalie Anne Hernaez
Background: Though protective levels of neonatal SARS-CoV2 IgG still warrant further studies, maternal antibodies from COVID-19 vaccination may be the key to neonatal protection against COVID-19 related complications. This study aimed to correlate SARS-CoV2 IgG titers of term newborns delivered to fully vaccinated/boosted mothers with the time of dose completion to delivery and the type of COVID-19 vaccine received by the mothers. Methodology: A single center prospective cohort study that utilized CLIA Anti-S-RBD IgG determination in cord blood was done. Kruskal-Wallis and Mann-Whitney U Test were used to determine significant differences between IgG titers from vaccine types and groups as to trimester when COVID-19 dose was completed. Spearman’s rank was used to determine the correlation between IgG levels and interval of dose completion to delivery. Results: All 177 newborns enrolled in the study had reactive results (> 1 AU/ml) regardless of vaccine type received and trimester of maternal vaccination completion. The highest titers recorded per group was 19,340 AU/ml from the booster group and 5,960 AU/ml from the primary series group. The mRNA vaccinated group exhibited higher titers compared to other vaccine types regardless of the trimester completion for both groups. Conclusions: A significant difference between IgG levels showed that higher titers were noted in the booster group compared to the primary series group across all trimesters. There was also a significant correlation between titer levels and time of dose completion to delivery with higher titers associated with more recent dose completion for both groups.
{"title":"The Coronavirus Disease 2019 (COVID-19) Immunoglobulin (IgG) Levels Using Chemiluminescence Immunoassay (CLIA) Anti-S-RBD Test in Term Neonates Born to COVID-19 Fully Vaccinated Mothers","authors":"Ray Mendoza, Belle Ranile, Nathalie Anne Hernaez","doi":"10.56964/pidspj20232402002","DOIUrl":"https://doi.org/10.56964/pidspj20232402002","url":null,"abstract":"Background: Though protective levels of neonatal SARS-CoV2 IgG still warrant further studies, maternal antibodies from COVID-19 vaccination may be the key to neonatal protection against COVID-19 related complications. This study aimed to correlate SARS-CoV2 IgG titers of term newborns delivered to fully vaccinated/boosted mothers with the time of dose completion to delivery and the type of COVID-19 vaccine received by the mothers. Methodology: A single center prospective cohort study that utilized CLIA Anti-S-RBD IgG determination in cord blood was done. Kruskal-Wallis and Mann-Whitney U Test were used to determine significant differences between IgG titers from vaccine types and groups as to trimester when COVID-19 dose was completed. Spearman’s rank was used to determine the correlation between IgG levels and interval of dose completion to delivery. Results: All 177 newborns enrolled in the study had reactive results (> 1 AU/ml) regardless of vaccine type received and trimester of maternal vaccination completion. The highest titers recorded per group was 19,340 AU/ml from the booster group and 5,960 AU/ml from the primary series group. The mRNA vaccinated group exhibited higher titers compared to other vaccine types regardless of the trimester completion for both groups. Conclusions: A significant difference between IgG levels showed that higher titers were noted in the booster group compared to the primary series group across all trimesters. There was also a significant correlation between titer levels and time of dose completion to delivery with higher titers associated with more recent dose completion for both groups.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"3 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139245591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-23DOI: 10.56964/pidspj20232402003
Hannah Tan, Arlene Dy-Co
Background: Tuberculosis remains to be a major cause of morbidity in children and treatment of latent tuberculosis is important to prevent children from developing active tuberculosis. This study aimed to compare the effectiveness, safety, compliance, and cost of the currently available Latent Tuberculosis Infection treatment regimens, 6 months isoniazid (6H) and 3 months isoniazid plus rifampicin (3HR), based on the 2020 Department of Health National Tuberculosis Control Program Tuberculosis Preventive Treatment guidelines for children. Methodology: In this open label randomized controlled trial pilot study, 30 participants were assigned to receive either 6H or 3HR. Medications were administered daily by either participants (with direct supervision of treatment supporters) or treatment supporters (for younger participants). Data on outcome measures in terms of effectiveness, safety, and compliance were obtained. Direct cost of treatment was computed per patient’s weight category. Independent Z-test for proportion (for effectiveness, safety, and compliance) and mean (for cost) at 5% level of significance was used to compare the outcomes for each treatment group. Results: Twelve subjects (67%) in the 6H group completed per-protocol therapy, compared to 10 subjects (87%) in the 3HR group. The proportion of adverse events was higher in the 6H group (22%) compared to the 3HR group (8%), but statistical tests showed no significant difference for both compliance and frequency of adverse events. No participant developed active TB disease in both groups. The cost of the 6H treatment regimen was 2,180.18 Php while the cost of the 3HR treatment regimen was 1,526.41 Php, with a p-value of 0.0470 which was statistically significant. Conclusions: Both 6H and 3HR are effective treatments for latent TB infection in patients 0-18 years old. Both treatments were comparable in terms of safety and ease of compliance, but overall cost was higher in the 6H treatment regimen.
{"title":"Comparison of the effectiveness, safety, compliance, and cost of the 6-month isoniazid vs 3-month isoniazid-rifampicin regimen for latent tuberculosis in children.","authors":"Hannah Tan, Arlene Dy-Co","doi":"10.56964/pidspj20232402003","DOIUrl":"https://doi.org/10.56964/pidspj20232402003","url":null,"abstract":"Background: Tuberculosis remains to be a major cause of morbidity in children and treatment of latent tuberculosis is important to prevent children from developing active tuberculosis. This study aimed to compare the effectiveness, safety, compliance, and cost of the currently available Latent Tuberculosis Infection treatment regimens, 6 months isoniazid (6H) and 3 months isoniazid plus rifampicin (3HR), based on the 2020 Department of Health National Tuberculosis Control Program Tuberculosis Preventive Treatment guidelines for children. Methodology: In this open label randomized controlled trial pilot study, 30 participants were assigned to receive either 6H or 3HR. Medications were administered daily by either participants (with direct supervision of treatment supporters) or treatment supporters (for younger participants). Data on outcome measures in terms of effectiveness, safety, and compliance were obtained. Direct cost of treatment was computed per patient’s weight category. Independent Z-test for proportion (for effectiveness, safety, and compliance) and mean (for cost) at 5% level of significance was used to compare the outcomes for each treatment group. Results: Twelve subjects (67%) in the 6H group completed per-protocol therapy, compared to 10 subjects (87%) in the 3HR group. The proportion of adverse events was higher in the 6H group (22%) compared to the 3HR group (8%), but statistical tests showed no significant difference for both compliance and frequency of adverse events. No participant developed active TB disease in both groups. The cost of the 6H treatment regimen was 2,180.18 Php while the cost of the 3HR treatment regimen was 1,526.41 Php, with a p-value of 0.0470 which was statistically significant. Conclusions: Both 6H and 3HR are effective treatments for latent TB infection in patients 0-18 years old. Both treatments were comparable in terms of safety and ease of compliance, but overall cost was higher in the 6H treatment regimen.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"152 5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139246008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-23DOI: 10.56964/pidspj20232402004
Josh Nathan Ngai, Kristian Dorell Masacupan, Allan Robert Racho, Maria Luz Del Rosario, Loralyn Mae Lagaya-Arañas, Imelda Luna
Objective: To evaluate the clinical and microbiological profile and factors affecting outcome among pediatric febrile neutropenic (FN) patients with hematologic malignancies (HM) Methodology: This was a cross-sectional study which looked into medical records of Filipino children 0-18years old diagnosed with FN and HM and admitted from June 2016 up to June 2022 at the St. Luke’s Medical Center, Quezon City (SLMC-QC). Data on age, sex, underlying malignancy, stage of treatment, site of infection, presence of central line, initial antibiotic therapy, culture positivity and isolates were retrospectively evaluated. Incomplete records were excluded. The relationship between clinical & microbiologic profile and outcomes were analyzed using T-test and Chi-square test. Significance was set at p<0.05. Results: This study included 267 episodes of FN. Patients had a mean age of 8.3 years with male preponderance (59%). The most frequent underlying malignancy was acute lymphoblastic leukemia (61%). Episodes occurred primarily during the induction (40%) and consolidation phases (28%) of chemotherapy. Most (65%) had an absolute neutrophil count (ANC) of <100/mm3. Central line catheter was present in 59% of episodes and 52% had an implanted port. There was no identifiable focus of infection in 52% of cases. Gram-negative bacteria, specifically Klebsiella pneumoniae (13%) and Escherichia coli (11%) were the most common isolates. Most patients (88%) recovered. Age >10years, male sex, diagnosis of acute myelogenous leukemia, relapse disease, ANC <100/mm3, presence of a central line, and central line associated bloodstream infection were significantly associated with duration of hospital stay. Presence of central venous line was the most significant factor associated with mortality. Conclusions: Several clinical and microbiological factors, specifically age >10years, male sex, diagnosis of acute myelogenous leukemia, relapse disease, ANC <100/mm3, presence of a central line, and central line associated bloodstream infection, were documented to significantly affect outcome in Filipino pediatric FN patients with HM.
目的评估小儿发热性中性粒细胞减少症（FN）合并血液系统恶性肿瘤（HM）患者的临床和微生物学特征以及影响预后的因素：这是一项横断面研究，调查了奎松城圣卢克医疗中心（SLMC-QC）自2016年6月至2022年6月期间收治的0-18岁菲律宾籍发热性中性粒细胞减少症和血液恶性肿瘤患儿的医疗记录。对患者的年龄、性别、基础恶性肿瘤、治疗阶段、感染部位、是否使用中心管、初始抗生素治疗、培养阳性率和分离物等数据进行了回顾性评估。不完整的记录被排除在外。采用 T 检验和卡方检验分析了临床和微生物学特征与结果之间的关系。在菲律宾儿科 FN HM 患者中，P10、男性性别、急性髓性白血病诊断、疾病复发、ANC 10 年、男性性别、急性髓性白血病诊断、疾病复发、ANC <100/mm3 、中心静脉置管和中心静脉置管相关血流感染被认为会对预后产生显著影响。
{"title":"Clinical and Microbiological Profile and Factors Affecting Outcome among Pediatric Febrile Neutropenic Patients with Hematologic Malignancies.","authors":"Josh Nathan Ngai, Kristian Dorell Masacupan, Allan Robert Racho, Maria Luz Del Rosario, Loralyn Mae Lagaya-Arañas, Imelda Luna","doi":"10.56964/pidspj20232402004","DOIUrl":"https://doi.org/10.56964/pidspj20232402004","url":null,"abstract":"Objective: To evaluate the clinical and microbiological profile and factors affecting outcome among pediatric febrile neutropenic (FN) patients with hematologic malignancies (HM) Methodology: This was a cross-sectional study which looked into medical records of Filipino children 0-18years old diagnosed with FN and HM and admitted from June 2016 up to June 2022 at the St. Luke’s Medical Center, Quezon City (SLMC-QC). Data on age, sex, underlying malignancy, stage of treatment, site of infection, presence of central line, initial antibiotic therapy, culture positivity and isolates were retrospectively evaluated. Incomplete records were excluded. The relationship between clinical & microbiologic profile and outcomes were analyzed using T-test and Chi-square test. Significance was set at p<0.05. Results: This study included 267 episodes of FN. Patients had a mean age of 8.3 years with male preponderance (59%). The most frequent underlying malignancy was acute lymphoblastic leukemia (61%). Episodes occurred primarily during the induction (40%) and consolidation phases (28%) of chemotherapy. Most (65%) had an absolute neutrophil count (ANC) of <100/mm3. Central line catheter was present in 59% of episodes and 52% had an implanted port. There was no identifiable focus of infection in 52% of cases. Gram-negative bacteria, specifically Klebsiella pneumoniae (13%) and Escherichia coli (11%) were the most common isolates. Most patients (88%) recovered. Age >10years, male sex, diagnosis of acute myelogenous leukemia, relapse disease, ANC <100/mm3, presence of a central line, and central line associated bloodstream infection were significantly associated with duration of hospital stay. Presence of central venous line was the most significant factor associated with mortality. Conclusions: Several clinical and microbiological factors, specifically age >10years, male sex, diagnosis of acute myelogenous leukemia, relapse disease, ANC <100/mm3, presence of a central line, and central line associated bloodstream infection, were documented to significantly affect outcome in Filipino pediatric FN patients with HM.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139243951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-23DOI: 10.56964/pidspj20232402001
Arlene Dy-Co
Before we say aye to an innovation whether in healthcare or other fields it is prudent to evaluate its merits and perils. The rapid rise of artificial intelligence (AI) has created both a growing excitement and cautious wary amongst many in the medical and research fields. And this includes the field of medical publishing. AI is being used today across different fields, also known as machine intelligence, it focuses on building and managing technology that can learn to autonomously make decisions and carry out actions on behalf of a person. As the technology has become more embedded in everyday applications, the interest focused on seeking to emulate the human brain through the design of programs and algorithms with real-time processing. Much debate about AI’s potential to revolutionize is countered with significant concerns. There are many areas in which AI is valuable in publishing from simple formatting, checking of grammar to the more complex like-text auto-tagging to improve discoverability of research and much more. It can improve and speed up many processes in the editorial workflow. Some of its potential drawbacks include concerns about privacy and data security, loss of personal touch and limited emotional connection, bias and possibly discriminatory algorithms and ethical concerns. Such that the International Committee of Medical Journal Editors (ICMJE) updated the criteria for authorship in the advent of AI. It states that chatbots should not be listed as authors because they cannot be responsible for the accuracy, integrity, and originality of a work, and these responsibilities are required for authorship. Authors should not list AI and AI-assisted technologies as an author or co-author, nor cite AI as an author. Further, ICMJE issued that journals should require authors to disclose whether they used artificial intelligence (AI)-assisted technologies in the production of submitted work. Authors who use such technology should describe, in both the cover letter and the submitted work, how they used it. While AI surely has an enormous potential for great advances much of their power comes from their ability to outperform human abilities in terms of speed and accuracy. I believe that AI’s existence in the medical publishing field is unavoidable. It is poised to have a dramatic influence in the way we share new discoveries, health advances and findings in research and innovations. At its best, it can spread landmark breakthroughs instantaneously but this makes accountability very critical to its application. I hope that measures will be employed to ensure that humans run the system—not the other way around.
{"title":"Aye, AI Captain!","authors":"Arlene Dy-Co","doi":"10.56964/pidspj20232402001","DOIUrl":"https://doi.org/10.56964/pidspj20232402001","url":null,"abstract":"Before we say aye to an innovation whether in healthcare or other fields it is prudent to evaluate its merits and perils. The rapid rise of artificial intelligence (AI) has created both a growing excitement and cautious wary amongst many in the medical and research fields. And this includes the field of medical publishing. AI is being used today across different fields, also known as machine intelligence, it focuses on building and managing technology that can learn to autonomously make decisions and carry out actions on behalf of a person. As the technology has become more embedded in everyday applications, the interest focused on seeking to emulate the human brain through the design of programs and algorithms with real-time processing. Much debate about AI’s potential to revolutionize is countered with significant concerns. There are many areas in which AI is valuable in publishing from simple formatting, checking of grammar to the more complex like-text auto-tagging to improve discoverability of research and much more. It can improve and speed up many processes in the editorial workflow. Some of its potential drawbacks include concerns about privacy and data security, loss of personal touch and limited emotional connection, bias and possibly discriminatory algorithms and ethical concerns. Such that the International Committee of Medical Journal Editors (ICMJE) updated the criteria for authorship in the advent of AI. It states that chatbots should not be listed as authors because they cannot be responsible for the accuracy, integrity, and originality of a work, and these responsibilities are required for authorship. Authors should not list AI and AI-assisted technologies as an author or co-author, nor cite AI as an author. Further, ICMJE issued that journals should require authors to disclose whether they used artificial intelligence (AI)-assisted technologies in the production of submitted work. Authors who use such technology should describe, in both the cover letter and the submitted work, how they used it. While AI surely has an enormous potential for great advances much of their power comes from their ability to outperform human abilities in terms of speed and accuracy. I believe that AI’s existence in the medical publishing field is unavoidable. It is poised to have a dramatic influence in the way we share new discoveries, health advances and findings in research and innovations. At its best, it can spread landmark breakthroughs instantaneously but this makes accountability very critical to its application. I hope that measures will be employed to ensure that humans run the system—not the other way around.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139244345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-23DOI: 10.56964/pidspj20232402005
Michelle Jane Manding, Expedito Yala
Background: Neonatal sepsis contributes to significant morbidity and mortality. Blood culture, the gold standard in its diagnosis, has low sensitivity and is affected by multiple factors. Hence the need for markers derived from routine tests to improve diagnosis deserves further studies. Objectives: This study aims to determine the association and optimal cut-off value and diagnostic performance of absolute neutrophil count (ANC) and neutrophil lymphocyte ratio (NLR) with early-onset neonatal sepsis in term neonates. Methodology: This was a retrospective, analytical, single-center study of admitted patients from January 2016 to December 2021. Clinical factors were analyzed and NLR and ANC were derived from CBC and interpreted using the Manroe chart. Results: Included were 200 neonates with a median birth AOG of 38 weeks. Microorganisms were isolated from nine of 154 neonates with blood culture, corresponding prevalence of 5.84% (95% CI 2.71–10.80). Initial CBC showed elevated mean WBC and 76.5% of neonates were considered to have elevated ANC. Optimal cut-off point of NLR for detecting culture-proven sepsis was 2.86, with a sensitivity of 88.89% (95% CI, 51.75–99.72%) and specificity of 36.55% (95% CI, 28.72–44.95%). The ANC gave the best balance of sensitivity and specificity with an accuracy of 75.50%. Conclusions: The NLR demonstrated good discriminative ability for predicting clinical neonatal sepsis based on ANC. However, individually or simultaneously, these markers demonstrated poor discriminative ability for culture-proven neonatal sepsis in term neonates. ANC and NLR can be used to aid in the diagnosis of clinical neonatal sepsis.
{"title":"The Use of Absolute Neutrophil Count and Neutrophil-Lymphocyte Ratio as Predictors of Early Onset Neonatal Sepsis.","authors":"Michelle Jane Manding, Expedito Yala","doi":"10.56964/pidspj20232402005","DOIUrl":"https://doi.org/10.56964/pidspj20232402005","url":null,"abstract":"Background: Neonatal sepsis contributes to significant morbidity and mortality. Blood culture, the gold standard in its diagnosis, has low sensitivity and is affected by multiple factors. Hence the need for markers derived from routine tests to improve diagnosis deserves further studies. Objectives: This study aims to determine the association and optimal cut-off value and diagnostic performance of absolute neutrophil count (ANC) and neutrophil lymphocyte ratio (NLR) with early-onset neonatal sepsis in term neonates. Methodology: This was a retrospective, analytical, single-center study of admitted patients from January 2016 to December 2021. Clinical factors were analyzed and NLR and ANC were derived from CBC and interpreted using the Manroe chart. Results: Included were 200 neonates with a median birth AOG of 38 weeks. Microorganisms were isolated from nine of 154 neonates with blood culture, corresponding prevalence of 5.84% (95% CI 2.71–10.80). Initial CBC showed elevated mean WBC and 76.5% of neonates were considered to have elevated ANC. Optimal cut-off point of NLR for detecting culture-proven sepsis was 2.86, with a sensitivity of 88.89% (95% CI, 51.75–99.72%) and specificity of 36.55% (95% CI, 28.72–44.95%). The ANC gave the best balance of sensitivity and specificity with an accuracy of 75.50%. Conclusions: The NLR demonstrated good discriminative ability for predicting clinical neonatal sepsis based on ANC. However, individually or simultaneously, these markers demonstrated poor discriminative ability for culture-proven neonatal sepsis in term neonates. ANC and NLR can be used to aid in the diagnosis of clinical neonatal sepsis.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139245884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-23DOI: 10.56964/pidspj20232402007
Aubrey Artienda, Jay Ron Padua
Objective: This study determined the association of SARS-CoV-2 RT-PCR cycle threshold (Ct) value with disease severity and mortality among hospitalized pediatric COVID-19 patients. Methodology: This is a retrospective cohort study of patients aged 0-18 years with SARS-CoV-2 RT-PCR-confirmed COVID-19 from 1-September-2020 to 31-August-2022. The cohort was divided into those with high (>30), medium (> 20) and low (
{"title":"SARS-CoV-2 RT-PCR cycle threshold value and its association with disease severity and mortality among hospitalized pediatric covid-19 patients.","authors":"Aubrey Artienda, Jay Ron Padua","doi":"10.56964/pidspj20232402007","DOIUrl":"https://doi.org/10.56964/pidspj20232402007","url":null,"abstract":"Objective: This study determined the association of SARS-CoV-2 RT-PCR cycle threshold (Ct) value with disease severity and mortality among hospitalized pediatric COVID-19 patients. Methodology: This is a retrospective cohort study of patients aged 0-18 years with SARS-CoV-2 RT-PCR-confirmed COVID-19 from 1-September-2020 to 31-August-2022. The cohort was divided into those with high (>30), medium (> 20) and low (</= 20) Ct values. Association between Ct values and disease severity was determined using Chi-square test and association between Ct values and mortality was determined using logistic regression. Results: There were 236 patients included with male predominance. Median age was 7 years. Most belonged to the 0-5 years age group. Most were severe to critical COVID-19 cases. Median day of illness on swab collection was 4 days. Majority presented with symptoms such as fever (54%), cough (22%) and dyspnea (22%). Eighty-four percent had co-morbidities, of which majority were cancer and neurologic diseases. Median Ct value was 30.81. Fifty-four percent had high Ct values. The median age of patients with a high Ct value was significantly lower than other cohorts. The median day of illness of patients with low Ct value was significantly shorter than other cohorts. There was no significant difference across the terciles in terms of presence of co-morbidities. Majority of patients for each cohort had high Ct values. There was no significant association between Ct value and COVID-19 disease severity on admission. Nearly fifty percent had critical disease and the all-cause mortality rate was 21.61%. There was no significant association between Ct value and mortality. Conclusions: Ct value was not associated with disease severity and all-cause mortality after controlling for confounders. A look into medical interventions, emergence of variants, and other factors that may affect the clinical presentation, disease course, severity and outcome are recommended in future studies.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139243596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-23DOI: 10.56964/pidspj20232402008
Arianne Calimlim-Samson, Carmina Delos Reyes, Germana Emerita Gregorio
Background: Acute cholangitis (AC) in children is a rare but life-threatening infection. Symptoms vary from mild to severe disease. There are no local published data on pediatric AC. Objective: To determine the clinical, biochemical, ultrasonographic, microbiologic features, and treatment outcome of pediatric patients with definite AC. Methodology: Cross-sectional study using medical records of pediatric patients diagnosed with definite AC based on the Modified Tokyo Guidelines of 2018 admitted from January 2016 to June 2021. Results: Twenty-seven patients aged 0 to 18 years old (10.06 + 7.34), predominantly male (51.85%) were included. Choledocholithiasis (22%) and post-Kasai biliary atresia (22%) were the common underlying biliary conditions. Fever (88.89%) was the most frequent presenting symptom. Majority were classified as moderate AC (40.74%). Leukocytosis (mean 16x109/L), elevated inflammatory markers (93.33% with CRP >12mg/L and 100% with serum procalcitonin >0.25ng/mL), hyperbilirubinemia (total bilirubin 192.54±126.87umol/L) and elevated alanine transferases (mean 59 IU/L) were noted. Twenty-one out of 27 cases (87%) had a negative blood culture. Only 4 patients underwent bile culture, of which two (50%) grew Klebsiella pneumoniae resistant to empiric antibiotics. Dilated biliary ducts were observed on abdominal ultrasound in 92.59% of patients. Ampicillin-sulbactam (29.63%) was the most commonly utilized antibiotic. Discharge rate was high (88.89%). Conclusions: AC affects all pediatric age groups but clinical presentations vary. Drug resistant organisms are a significant concern but despite this, favorable outcomes have been documented.
{"title":"Clinical Profile and Treatment Outcomes Of Acute Cholangitis in Children in a Tertiary Government Hospital in the Philippines: A Five-Year Retrospective Study.","authors":"Arianne Calimlim-Samson, Carmina Delos Reyes, Germana Emerita Gregorio","doi":"10.56964/pidspj20232402008","DOIUrl":"https://doi.org/10.56964/pidspj20232402008","url":null,"abstract":"Background: Acute cholangitis (AC) in children is a rare but life-threatening infection. Symptoms vary from mild to severe disease. There are no local published data on pediatric AC. Objective: To determine the clinical, biochemical, ultrasonographic, microbiologic features, and treatment outcome of pediatric patients with definite AC. Methodology: Cross-sectional study using medical records of pediatric patients diagnosed with definite AC based on the Modified Tokyo Guidelines of 2018 admitted from January 2016 to June 2021. Results: Twenty-seven patients aged 0 to 18 years old (10.06 + 7.34), predominantly male (51.85%) were included. Choledocholithiasis (22%) and post-Kasai biliary atresia (22%) were the common underlying biliary conditions. Fever (88.89%) was the most frequent presenting symptom. Majority were classified as moderate AC (40.74%). Leukocytosis (mean 16x109/L), elevated inflammatory markers (93.33% with CRP >12mg/L and 100% with serum procalcitonin >0.25ng/mL), hyperbilirubinemia (total bilirubin 192.54±126.87umol/L) and elevated alanine transferases (mean 59 IU/L) were noted. Twenty-one out of 27 cases (87%) had a negative blood culture. Only 4 patients underwent bile culture, of which two (50%) grew Klebsiella pneumoniae resistant to empiric antibiotics. Dilated biliary ducts were observed on abdominal ultrasound in 92.59% of patients. Ampicillin-sulbactam (29.63%) was the most commonly utilized antibiotic. Discharge rate was high (88.89%). Conclusions: AC affects all pediatric age groups but clinical presentations vary. Drug resistant organisms are a significant concern but despite this, favorable outcomes have been documented.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139243108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-03DOI: 10.56964/pidspj20232401004
Ma. Vina Jalandoni-Cabahug, M. R. Capeding, Kristine Alvarado-Dela Cruz, Mark Joseph Castellano, Maria Nerissa De Leon, Jay Ron Padua
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.
{"title":"2021 CLINICAL PRACTICE GUIDELINES IN THE EVALUATION AND MANAGEMENT OF PEDIATRIC COMMUNITY-ACQUIRED PNEUMONIA","authors":"Ma. Vina Jalandoni-Cabahug, M. R. Capeding, Kristine Alvarado-Dela Cruz, Mark Joseph Castellano, Maria Nerissa De Leon, Jay Ron Padua","doi":"10.56964/pidspj20232401004","DOIUrl":"https://doi.org/10.56964/pidspj20232401004","url":null,"abstract":"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.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128318821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-03DOI: 10.56964/pidspj20232401002
Maria Anna Bañez, M. Marasigan, Marshall Gonzales, G. Go, Fatima Gimenez, M. A. Madrid
Leptospirosis is a disease prevalent mostly in tropical and subtropical countries. Its potential to be a concerning problem emerges with the onset of the rainy season, as flooding and heavy rainfall facilitate disease epidemics. Among those at risk of contracting the disease are field workers, veterinarians, sewer workers, military personnel and those who swim or wade in contaminated waters. In the absence of an existing evidence-based guideline for the pediatric age group, this first edition hopes to standardize approach to diagnosis, antibiotic management, and prevention of leptospirosis. The intended users are primary care physicians, family medicine physicians, pediatricians, and other healthcare workers involved in the management of leptospirosis in children. Ten priority questions were identified by a group of experts composed of an oversight committee, a guideline writing panel, and a technical review committee. The GRADE methodology was used to determine the quality of evidence of each recommendation. The draft recommendations (summarized below) were finalized after these were presented to and voted on by a panel of stakeholders.
{"title":"CLINICAL PRACTICE GUIDELINES ON LEPTOSPIROSIS IN CHILDREN 2019","authors":"Maria Anna Bañez, M. Marasigan, Marshall Gonzales, G. Go, Fatima Gimenez, M. A. Madrid","doi":"10.56964/pidspj20232401002","DOIUrl":"https://doi.org/10.56964/pidspj20232401002","url":null,"abstract":"Leptospirosis is a disease prevalent mostly in tropical and subtropical countries. Its potential to be a concerning problem emerges with the onset of the rainy season, as flooding and heavy rainfall facilitate disease epidemics. Among those at risk of contracting the disease are field workers, veterinarians, sewer workers, military personnel and those who swim or wade in contaminated waters. In the absence of an existing evidence-based guideline for the pediatric age group, this first edition hopes to standardize approach to diagnosis, antibiotic management, and prevention of leptospirosis. The intended users are primary care physicians, family medicine physicians, pediatricians, and other healthcare workers involved in the management of leptospirosis in children. Ten priority questions were identified by a group of experts composed of an oversight committee, a guideline writing panel, and a technical review committee. The GRADE methodology was used to determine the quality of evidence of each recommendation. The draft recommendations (summarized below) were finalized after these were presented to and voted on by a panel of stakeholders.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129966752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-03DOI: 10.56964/pidspj20232401001
Carmina Delos Reyes
Medical guidelines are documents containing recommendations which can be used in clinical practice. They are intended to help physicians make informed decisions on diagnostic or treatment dilemmas and help achieve the best outcomes for patients. Medical guidelines are not made overnight. Members of the guidelines development committee, composed of a multidisciplinary panel of experts from key groups, are carefully chosen to produce a high qualityscientificdocument. Thisisachievedthrough atransparent,evidence-baseddecision-makingprocess that is labor intensive and rigorous. This ensures that guidelines are sound, credible and at par with international standards. The process starts by defining the topic and scope for guideline development. Key issues and questions regarding the topic are drafted. Review of questions, literature search, evidence reviews, and committee discussions are done. Available medical evidence are summarized, and grading of evidence is made, until a draft recommendation is developed. Draft guidelines are then reviewed by stakeholders until a final guideline is produced and published. In this special issue, we bring you outputs from this guideline development process - four relevant documents on COVID-19, Pediatric Community Acquired Pneumonia (in collaboration with the Philippine Academy of Pediatric Pulmonologists), Leptospirosis, and Pediatric Immunization (prepared by the National Institutes of Health-Institute of Clinical Epidemiology and funded by the Department of Health ). The guideline development process is imperfect. Some shortcomings include paucity of evidence on certain questions, presence of potential conflicts of interest among members of the committee, limitations in funding, and even time. The major advantage is access to a summarized wealth of evidence on a specific topic to enhance physician expertise, improve healthcare quality, and reduce healthcare cost. Guidelines can also influence health policies so that underrecognized health concerns and services can be made available to the majority. Guidelines should be used with the best interest of the individual patient in mind. They help to improve patient care quality. The complex medical decision making process done by the physician however, should not be limited by simplistic algorithms suggested by guidelines.
{"title":"THE GENIUS BEHIND GUIDELINES","authors":"Carmina Delos Reyes","doi":"10.56964/pidspj20232401001","DOIUrl":"https://doi.org/10.56964/pidspj20232401001","url":null,"abstract":"Medical guidelines are documents containing recommendations which can be used in clinical practice. They are intended to help physicians make informed decisions on diagnostic or treatment dilemmas and help achieve the best outcomes for patients. Medical guidelines are not made overnight. Members of the guidelines development committee, composed of a multidisciplinary panel of experts from key groups, are carefully chosen to produce a high qualityscientificdocument. Thisisachievedthrough atransparent,evidence-baseddecision-makingprocess that is labor intensive and rigorous. This ensures that guidelines are sound, credible and at par with international standards. The process starts by defining the topic and scope for guideline development. Key issues and questions regarding the topic are drafted. Review of questions, literature search, evidence reviews, and committee discussions are done. Available medical evidence are summarized, and grading of evidence is made, until a draft recommendation is developed. Draft guidelines are then reviewed by stakeholders until a final guideline is produced and published. In this special issue, we bring you outputs from this guideline development process - four relevant documents on COVID-19, Pediatric Community Acquired Pneumonia (in collaboration with the Philippine Academy of Pediatric Pulmonologists), Leptospirosis, and Pediatric Immunization (prepared by the National Institutes of Health-Institute of Clinical Epidemiology and funded by the Department of Health ). The guideline development process is imperfect. Some shortcomings include paucity of evidence on certain questions, presence of potential conflicts of interest among members of the committee, limitations in funding, and even time. The major advantage is access to a summarized wealth of evidence on a specific topic to enhance physician expertise, improve healthcare quality, and reduce healthcare cost. Guidelines can also influence health policies so that underrecognized health concerns and services can be made available to the majority. Guidelines should be used with the best interest of the individual patient in mind. They help to improve patient care quality. The complex medical decision making process done by the physician however, should not be limited by simplistic algorithms suggested by guidelines.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"62 28","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133087155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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