Pub Date : 2021-05-21DOI: 10.56964/pidspj2021220107
Anna Soleil Cheshia Tan
Background: Our country has the fastest growing number of HIV cases in the Asia-Pacific region with a 203% increase from 2010 to 2018. MTCT represents 6% of infections in children and interventions such as the PMTCT program are essential to help reduce new infant infections. Objective: To determine the outcomes of HIV-exposed infants born in PGH from 2010 to 2018 enrolled in the PMTCT program. To analyze the association of maternal and neonatal clinicodemographic factors to MTCT of HIV. Methods: A retrospective cohort study using data collected from medical records of HIV exposed infants enrolled in the program. Results: Out of 117 mother-infant pairs, only 70 met the eligibility criteria. Maternal factors showed that majority have: timely antenatal visit (56/70), maternal HIV diagnosis (70/70) and ART initiation (67/70) prior to delivery, triple lifelong maternal ART (69/70), CD4 >200 prior to delivery (52/70) and cesarean delivery (67/70). Amongst the infant factors-early infant prophylaxis (60/62), >4weeks prophylaxis duration (62/70) and replacement feeding (62/70) were noted in the majority. 2/70 infants were HIV positive. Mortality rate was 1.4% and 50% for HIV infected infants. Overall LTFU rate was 33.3%. Logistic regression showed that maternal co-infection with Hepatitis B(p=0.0275) was a possible determinant of MTCT. Infant HIV prophylaxis duration of >4 weeks had higher survival proportion(p=.0001). Conclusion: The HIV MTCT rate was 2.86% upon implementation of our PMTCT program, meeting the <5% goal of WHO, suggesting that the program was an effective health intervention strategy. The high LTFU rate though should be considered in the evaluation of the program effectiveness.
{"title":"Outcomes of HIV-Exposed Infants enrolled in the Prevention of Mother to Child Transmission of HIV (PMTCT) Program in Philippine General Hospital: An 8-year Retrospective Study","authors":"Anna Soleil Cheshia Tan","doi":"10.56964/pidspj2021220107","DOIUrl":"https://doi.org/10.56964/pidspj2021220107","url":null,"abstract":"Background: Our country has the fastest growing number of HIV cases in the Asia-Pacific region with a 203% increase from 2010 to 2018. MTCT represents 6% of infections in children and interventions such as the PMTCT program are essential to help reduce new infant infections. Objective: To determine the outcomes of HIV-exposed infants born in PGH from 2010 to 2018 enrolled in the PMTCT program. To analyze the association of maternal and neonatal clinicodemographic factors to MTCT of HIV. Methods: A retrospective cohort study using data collected from medical records of HIV exposed infants enrolled in the program. Results: Out of 117 mother-infant pairs, only 70 met the eligibility criteria. Maternal factors showed that majority have: timely antenatal visit (56/70), maternal HIV diagnosis (70/70) and ART initiation (67/70) prior to delivery, triple lifelong maternal ART (69/70), CD4 >200 prior to delivery (52/70) and cesarean delivery (67/70). Amongst the infant factors-early infant prophylaxis (60/62), >4weeks prophylaxis duration (62/70) and replacement feeding (62/70) were noted in the majority. 2/70 infants were HIV positive. Mortality rate was 1.4% and 50% for HIV infected infants. Overall LTFU rate was 33.3%. Logistic regression showed that maternal co-infection with Hepatitis B(p=0.0275) was a possible determinant of MTCT. Infant HIV prophylaxis duration of >4 weeks had higher survival proportion(p=.0001). Conclusion: The HIV MTCT rate was 2.86% upon implementation of our PMTCT program, meeting the <5% goal of WHO, suggesting that the program was an effective health intervention strategy. The high LTFU rate though should be considered in the evaluation of the program effectiveness.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125229361","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 : 2021-05-21DOI: 10.56964/pidspj2021220103
Jerrymae Blasurca
Respiratory symptoms are the most common manifestation of COVID-19 across all age groups and it is most often associated with radiographical findings consistent with pneumonia.2 A recent systematic review estimated that 16% of children with SARS-CoV-2 infection are asymptomatic,3 or others may present with seizures, gastrointestinal bleeding or jaundice. This reports a 2-year old boy with no known co-morbidity who had a 2-week history of abdominal pain and jaundice then had a rapidly progressive course of neurological deterioration and eventual demise. He had markedly elevated liver enzymes and deranged bleeding parameters with elevated ammonia and ferritin levels. Hepatitis B and hepatitis A titers were non-reactive. He was managed as a case of hepatic encephalopathy secondary to cholestatic jaundice. His chest x-ray was normal but his SARS-CoV-2 RT PCR result was positive with a low cycle threshold. Locally, this is the first reported case of SARS-CoV-2 RT-PCR positive pediatric patient presenting as fulminant hepatic failure with no associated respiratory manifestations. Clinicians should be mindful that such presentation, however uncommon, is possible and a high index of suspicion should be maintained.
{"title":"Fulminant Hepatic Failure in a SARS-CoV-2 Positive Pediatric Patient: A Case Report","authors":"Jerrymae Blasurca","doi":"10.56964/pidspj2021220103","DOIUrl":"https://doi.org/10.56964/pidspj2021220103","url":null,"abstract":"Respiratory symptoms are the most common manifestation of COVID-19 across all age groups and it is most often associated with radiographical findings consistent with pneumonia.2 A recent systematic review estimated that 16% of children with SARS-CoV-2 infection are asymptomatic,3 or others may present with seizures, gastrointestinal bleeding or jaundice. This reports a 2-year old boy with no known co-morbidity who had a 2-week history of abdominal pain and jaundice then had a rapidly progressive course of neurological deterioration and eventual demise. He had markedly elevated liver enzymes and deranged bleeding parameters with elevated ammonia and ferritin levels. Hepatitis B and hepatitis A titers were non-reactive. He was managed as a case of hepatic encephalopathy secondary to cholestatic jaundice. His chest x-ray was normal but his SARS-CoV-2 RT PCR result was positive with a low cycle threshold. Locally, this is the first reported case of SARS-CoV-2 RT-PCR positive pediatric patient presenting as fulminant hepatic failure with no associated respiratory manifestations. Clinicians should be mindful that such presentation, however uncommon, is possible and a high index of suspicion should be maintained.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114440429","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 : 2020-12-01DOI: 10.56964/pidspj20202102007
Marimel Reyes-Pagcatipunan
An outbreak caused by the novel SARS-CoV-2 was declared by the World Health Organization (WHO) on January 30, 2020 as a public health emergency of international concern.1 In the Philippines, the first identified COVID 19 case was on January 16, 2020. On March 11, 2020 the WHO determined that it reached pandemic classification with widespread community transmission across the world.1 On March 16, 2020, an enhanced community quarantine (ECQ) was initiated in the National Capital Region (NCR) in the Philippines as a measure to control the spread of COVID -19 infection.
{"title":"Outbreak Response Measures for the Pediatric COVID 19 Ward at the Philippine General Hospital","authors":"Marimel Reyes-Pagcatipunan","doi":"10.56964/pidspj20202102007","DOIUrl":"https://doi.org/10.56964/pidspj20202102007","url":null,"abstract":"An outbreak caused by the novel SARS-CoV-2 was declared by the World Health Organization (WHO) on January 30, 2020 as a public health emergency of international concern.1 In the Philippines, the first identified COVID 19 case was on January 16, 2020. On March 11, 2020 the WHO determined that it reached pandemic classification with widespread community transmission across the world.1 On March 16, 2020, an enhanced community quarantine (ECQ) was initiated in the National Capital Region (NCR) in the Philippines as a measure to control the spread of COVID -19 infection.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126091670","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 : 2020-12-01DOI: 10.56964/pidspj20202102008
Charisse Leanne B. Legaspi
Skin mycoses have been a major problem affecting millions around the globe. The threat of resistance to synthetic antifungal agents however is a major obstacle in its management. As an alternative to these, a thorough investigation of natural products is being performed to develop medicines that are effective and safe. In this review, we described three antifungal herbal plants that are available in the Philippines, namely Senna alata (Linn.) Roxb. (akapulko), Allium sativum (Linn.) (garlic) and Cymbopogon citratus (DC.) Stapf (lemongrass). In vitro studies showed promising results that can be used as a basis for drug formulation for community use as well as commercial products. So far, there have been no reported toxic effects from these plants. The common ground for these plants’ mechanism of action was the effect of their phytochemicals in the cell membrane and cell wall organelles, inhibition of major biosynthetic pathways, and prevention of biofilm formation. Formulation and clinical studies also revealed promising results comparable to the synthetic ones.
{"title":"Medicinal Plants for Dermatophytosis: Senna Alata (Linn.) Roxb., Allium sativum (Linn.) and Cymbopogon citratus (DC.) Stapf","authors":"Charisse Leanne B. Legaspi","doi":"10.56964/pidspj20202102008","DOIUrl":"https://doi.org/10.56964/pidspj20202102008","url":null,"abstract":"Skin mycoses have been a major problem affecting millions around the globe. The threat of resistance to synthetic antifungal agents however is a major obstacle in its management. As an alternative to these, a thorough investigation of natural products is being performed to develop medicines that are effective and safe. In this review, we described three antifungal herbal plants that are available in the Philippines, namely Senna alata (Linn.) Roxb. (akapulko), Allium sativum (Linn.) (garlic) and Cymbopogon citratus (DC.) Stapf (lemongrass). In vitro studies showed promising results that can be used as a basis for drug formulation for community use as well as commercial products. So far, there have been no reported toxic effects from these plants. The common ground for these plants’ mechanism of action was the effect of their phytochemicals in the cell membrane and cell wall organelles, inhibition of major biosynthetic pathways, and prevention of biofilm formation. Formulation and clinical studies also revealed promising results comparable to the synthetic ones.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126700987","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 : 2020-12-01DOI: 10.56964/pidspj20202102005
Edelsa Azurin, Anne Kristine Claire Marasigan, Joanna Valerie Ang
Background: Neonatal sepsis, a clinical syndrome characterized by non-specific signs and symptoms, is the most common cause of neonatal mortality and morbidity. It is classified into early or late-onset depending on the onset of symptoms, if within the first 72 hours or later. Early onset sepsis (EOS) occurs due to ascending infection following rupture of membranes or during passage through an infected birth canal. Late onset sepsis (LOS) can be nosocomial or community-acquired. A high index of suspicion and timely and judicious use of antibiotics are needed to achieve good outcomes. Objective: This study looked into the clinical and bacteriologic profile of neonatal sepsis in a tertiary care hospital from January 2013 to December 2017. Methodology: This was a retrospective observational study. Data on maternal risk factors, mode of delivery, gestational age, birth weight, birth setting, clinical manifestations, and blood culture and sensitivity were gathered. Descriptive statistics was used to analyze the data. Results: Majority of cases were late onset sepsis with an equal distribution in those born via normal spontaneous delivery (NSD) and cesarean section (CS). There were more culture- positives in low birth weight (LBW) infants and those not delivered within a hospital. The most common maternal risk factor was UTI. Majority of culture-positive newborns presented with respiratory distress, poor feeding, fever, and irritability with respiratory distress being the most common manifestation for both EOS and LOS. Predominant isolates were CONS, E. coli and Klebsiella sp. Both E. coli and Klebsiella were resistant to both first-line empiric antibiotics – ampicillin and gentamicin but highly sensitive to piperacillin-tazobactam and imipenem. Conclusion: Clinical signs and symptoms of neonatal sepsis are non-specific. The presence of respiratory distress, fever, poor feeding, and irritability together with other risk factors should raise suspicion for sepsis and prompt investigation and treatment. Predominant isolates seen were CONS, E. coli and Klebsiella sp. with resistance to first-line empiric antibiotics.
{"title":"Clinical and Bacteriologic Profile of Neonatal Sepsis in a Tertiary Care Hospital: A 5-Year Review","authors":"Edelsa Azurin, Anne Kristine Claire Marasigan, Joanna Valerie Ang","doi":"10.56964/pidspj20202102005","DOIUrl":"https://doi.org/10.56964/pidspj20202102005","url":null,"abstract":"Background: Neonatal sepsis, a clinical syndrome characterized by non-specific signs and symptoms, is the most common cause of neonatal mortality and morbidity. It is classified into early or late-onset depending on the onset of symptoms, if within the first 72 hours or later. Early onset sepsis (EOS) occurs due to ascending infection following rupture of membranes or during passage through an infected birth canal. Late onset sepsis (LOS) can be nosocomial or community-acquired. A high index of suspicion and timely and judicious use of antibiotics are needed to achieve good outcomes. Objective: This study looked into the clinical and bacteriologic profile of neonatal sepsis in a tertiary care hospital from January 2013 to December 2017. Methodology: This was a retrospective observational study. Data on maternal risk factors, mode of delivery, gestational age, birth weight, birth setting, clinical manifestations, and blood culture and sensitivity were gathered. Descriptive statistics was used to analyze the data. Results: Majority of cases were late onset sepsis with an equal distribution in those born via normal spontaneous delivery (NSD) and cesarean section (CS). There were more culture- positives in low birth weight (LBW) infants and those not delivered within a hospital. The most common maternal risk factor was UTI. Majority of culture-positive newborns presented with respiratory distress, poor feeding, fever, and irritability with respiratory distress being the most common manifestation for both EOS and LOS. Predominant isolates were CONS, E. coli and Klebsiella sp. Both E. coli and Klebsiella were resistant to both first-line empiric antibiotics – ampicillin and gentamicin but highly sensitive to piperacillin-tazobactam and imipenem. Conclusion: Clinical signs and symptoms of neonatal sepsis are non-specific. The presence of respiratory distress, fever, poor feeding, and irritability together with other risk factors should raise suspicion for sepsis and prompt investigation and treatment. Predominant isolates seen were CONS, E. coli and Klebsiella sp. with resistance to first-line empiric antibiotics.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121335376","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 : 2020-12-01DOI: 10.56964/pidspj20202102001
Arlene Dy-Co
Amidst the ongoing COVID-19 Pandemic, we wonder when everything will settle down. Lives have been lost… one too many, livelihoods disrupted, events cancelled, travel plans placed on the back burner and education halted. Our country has the highest number of cases in our part of the world. We had the longest lockdown too.
{"title":"Time-Out","authors":"Arlene Dy-Co","doi":"10.56964/pidspj20202102001","DOIUrl":"https://doi.org/10.56964/pidspj20202102001","url":null,"abstract":"Amidst the ongoing COVID-19 Pandemic, we wonder when everything will settle down. Lives have been lost… one too many, livelihoods disrupted, events cancelled, travel plans placed on the back burner and education halted. Our country has the highest number of cases in our part of the world. We had the longest lockdown too.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"24 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115635882","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}
Background: Exclusive breastfeeding up to 6 months of age is the global recommendation of the World Health Organization because of its established benefits. Previous studies show that exclusive breastfeeding can protect infants during infancy but effects of breastfeeding beyond infancy are inconclusive. This study aims to identify if exclusive breastfeeding up to 6 months of age is protective for pneumonia up to 5 years of age. Methods: Systematic literature search was conducted on the following electronic databases: Pubmed, MEDLINE, EMBASE, CINAHL, SciHub, Herdin, Google Scholar, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews to identify all relevant studies assessing the effect of exclusive breastfeeding on development of pneumonia in children from birth to 5 years of age. Fixed effects meta-analysis was performed to generate pooled effect estimates (odds ratio) on the probability of developing pneumonia up to 5 years of age in exclusively breastfed compared to non-exclusively breastfed infants. Results: Five studies were included in the analysis. Exclusive breastfeeding from birth to 6 months has a protective effect against pneumonia in children up to 5 years of age. The probability of developing pneumonia in children until 5 years of age was significantly lower in those who were exclusively breastfed compared to those who were not exclusively breastfed (OR=0.86; 95%CI=0.77-0.95, pvalue=0.003) by 23%. Systematic review showed benefit of exclusive breastfeeding and continued breastfeeding for longer protection against developing pneumonia. Conclusion: Exclusive breastfeeding from birth to 6 months is associated with statistically significant reduction in the incidence of pneumonia up to 5 years of age. Results highlighted the importance of exclusive breastfeeding up to 6 months of age as an intervention in reducing pneumonia morbidity up to 5 years of age, thereby supporting the global recommendation of breastfeeding.
{"title":"Exclusive Breastfeeding from Birth to 6 Months for Reducing Community Acquired Pneumonia in Children Up to 5 Years of Age: A Systematic Review and Meta-Analysis","authors":"Vanessa Amor Dizon- Ditangco, Rebecca Abiog-Castro","doi":"10.56964/pidspj20202102003","DOIUrl":"https://doi.org/10.56964/pidspj20202102003","url":null,"abstract":"Background: Exclusive breastfeeding up to 6 months of age is the global recommendation of the World Health Organization because of its established benefits. Previous studies show that exclusive breastfeeding can protect infants during infancy but effects of breastfeeding beyond infancy are inconclusive. This study aims to identify if exclusive breastfeeding up to 6 months of age is protective for pneumonia up to 5 years of age. Methods: Systematic literature search was conducted on the following electronic databases: Pubmed, MEDLINE, EMBASE, CINAHL, SciHub, Herdin, Google Scholar, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews to identify all relevant studies assessing the effect of exclusive breastfeeding on development of pneumonia in children from birth to 5 years of age. Fixed effects meta-analysis was performed to generate pooled effect estimates (odds ratio) on the probability of developing pneumonia up to 5 years of age in exclusively breastfed compared to non-exclusively breastfed infants. Results: Five studies were included in the analysis. Exclusive breastfeeding from birth to 6 months has a protective effect against pneumonia in children up to 5 years of age. The probability of developing pneumonia in children until 5 years of age was significantly lower in those who were exclusively breastfed compared to those who were not exclusively breastfed (OR=0.86; 95%CI=0.77-0.95, pvalue=0.003) by 23%. Systematic review showed benefit of exclusive breastfeeding and continued breastfeeding for longer protection against developing pneumonia. Conclusion: Exclusive breastfeeding from birth to 6 months is associated with statistically significant reduction in the incidence of pneumonia up to 5 years of age. Results highlighted the importance of exclusive breastfeeding up to 6 months of age as an intervention in reducing pneumonia morbidity up to 5 years of age, thereby supporting the global recommendation of breastfeeding.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123058662","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 : 2020-12-01DOI: 10.56964/pidspj20202102002
Ailyn Manglicmot-Yabes, S. Y. Villanueva, N. Gloriani
Introduction: Leptospirosis is one of the neglected reemerging zoonoses that is of public health concern globally. The need to discover novel therapeutic alternatives for leptospirosis through screening for and elucidating the mechanism/s of the anti-leptospiral activity of plant extracts is therefore necessary. This study analyzes the optimized tube dilution technique and the BiologTM sole carbon utilization phenotype microarray as screening tool for anti-leptospiral activity of plant extracts. Methods: The suitability of the optimized tube dilution technique was evaluated by determining the minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and motility inhibition property of a plant extract and an antimicrobial control (pen G) against 4 dominantly circulating Leptospira serovars/serogroup in the Philippines. Likewise, the suitability of the BiologTM sole carbon utilization assay was evaluated using a plant extract and selected antimicrobials against L. interrogans serovar Manilae strain K64 and L. interrogans serovar Losbanos strain K37. Results: The MIC, MBC, and motility inhibition property of a plant extract and the antibiotic controls as well as its effect on the carbon utilization phenome of the Leptospira serovars gave consistent results, within and between several runs. With standard deviation = 0 for all serovars. The MIC and MBC of the antimicrobial control (pen G), the positive control, was 10 ug/ml. The growth control (leptospires without treatment), the negative control, showed presence of motile leptospires. The MIC and the MBC of the test plant extract was 250 ug/ml – 500 ug/ml. Results of the carbon utilization phenome or pattern of carbon utilization were consistent within the 3 replicates and between two runs. Conclusion: The optimized tube dilution technique and the BiologTM sole carbon utilization assay is a potential in vitro screening tool for determining anti-leptospiral activity of plant extracts.
{"title":"Optimized Tube Dilution Technique and Sole Carbon Utilization Assay for Anti-leptospiral In Vitro Screening of Plant Extracts","authors":"Ailyn Manglicmot-Yabes, S. Y. Villanueva, N. Gloriani","doi":"10.56964/pidspj20202102002","DOIUrl":"https://doi.org/10.56964/pidspj20202102002","url":null,"abstract":"Introduction: Leptospirosis is one of the neglected reemerging zoonoses that is of public health concern globally. The need to discover novel therapeutic alternatives for leptospirosis through screening for and elucidating the mechanism/s of the anti-leptospiral activity of plant extracts is therefore necessary. This study analyzes the optimized tube dilution technique and the BiologTM sole carbon utilization phenotype microarray as screening tool for anti-leptospiral activity of plant extracts. Methods: The suitability of the optimized tube dilution technique was evaluated by determining the minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and motility inhibition property of a plant extract and an antimicrobial control (pen G) against 4 dominantly circulating Leptospira serovars/serogroup in the Philippines. Likewise, the suitability of the BiologTM sole carbon utilization assay was evaluated using a plant extract and selected antimicrobials against L. interrogans serovar Manilae strain K64 and L. interrogans serovar Losbanos strain K37. Results: The MIC, MBC, and motility inhibition property of a plant extract and the antibiotic controls as well as its effect on the carbon utilization phenome of the Leptospira serovars gave consistent results, within and between several runs. With standard deviation = 0 for all serovars. The MIC and MBC of the antimicrobial control (pen G), the positive control, was 10 ug/ml. The growth control (leptospires without treatment), the negative control, showed presence of motile leptospires. The MIC and the MBC of the test plant extract was 250 ug/ml – 500 ug/ml. Results of the carbon utilization phenome or pattern of carbon utilization were consistent within the 3 replicates and between two runs. Conclusion: The optimized tube dilution technique and the BiologTM sole carbon utilization assay is a potential in vitro screening tool for determining anti-leptospiral activity of plant extracts.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117280946","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 : 2020-12-01DOI: 10.56964/pidspj20202102006
Mark Jensen Sy, F. Ty
Background: Typhoid fever, also known as enteric fever, is a severe systemic illness characterized by fever and gastrointestinal manifestations that commonly affects children and young adults. It is most prevalent in SouthCentral Asia, Southern Africa, and Southeast Asia. Alternative drugs for the treatment of enteric fever have been studied to decrease toxicity and increase compliance. Oral azithromycin has been proposed and is widely studied as a suitable treatment alternative. Objective: The objective of this study is to compare oral azithromycin with intravenous ceftriaxone in the treatment of uncomplicated typhoid fever in terms of cure, duration of fever, relapse, and adverse events. Methodology: A systematic review and meta-analysis were done with eligible studies taken from PUBMED, MEDLINE, and Cochrane Clinical Trial Registry. Six studies passed the eligibility criteria and were analyzed using Review Manager 5.3. Results: Azithromycin showed comparable results with ceftriaxone in terms of cure, duration of fever and adverse events. However, azithromycin proved superior in decreasing relapse. Conclusion: Azithromycin is comparable to ceftriaxone in the treatment of uncomplicated typhoid fever in terms of cure, duration of fever, and occurrence of adverse events. Azithromycin likewise had a lower incidence of relapse. Recommendations: We recommend conducting local trials in pediatric patients, to compare azithromycin with standard antibiotic regimen for typhoid fever, to help update local recommendations and expand choices for antibiotic use.
{"title":"Oral Azithromycin Vs Intravenous Ceftriaxone in the Treatment of Enteric Fever: A Systematic Review and Meta-Analysis","authors":"Mark Jensen Sy, F. Ty","doi":"10.56964/pidspj20202102006","DOIUrl":"https://doi.org/10.56964/pidspj20202102006","url":null,"abstract":"Background: Typhoid fever, also known as enteric fever, is a severe systemic illness characterized by fever and gastrointestinal manifestations that commonly affects children and young adults. It is most prevalent in SouthCentral Asia, Southern Africa, and Southeast Asia. Alternative drugs for the treatment of enteric fever have been studied to decrease toxicity and increase compliance. Oral azithromycin has been proposed and is widely studied as a suitable treatment alternative. Objective: The objective of this study is to compare oral azithromycin with intravenous ceftriaxone in the treatment of uncomplicated typhoid fever in terms of cure, duration of fever, relapse, and adverse events. Methodology: A systematic review and meta-analysis were done with eligible studies taken from PUBMED, MEDLINE, and Cochrane Clinical Trial Registry. Six studies passed the eligibility criteria and were analyzed using Review Manager 5.3. Results: Azithromycin showed comparable results with ceftriaxone in terms of cure, duration of fever and adverse events. However, azithromycin proved superior in decreasing relapse. Conclusion: Azithromycin is comparable to ceftriaxone in the treatment of uncomplicated typhoid fever in terms of cure, duration of fever, and occurrence of adverse events. Azithromycin likewise had a lower incidence of relapse. Recommendations: We recommend conducting local trials in pediatric patients, to compare azithromycin with standard antibiotic regimen for typhoid fever, to help update local recommendations and expand choices for antibiotic use.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115731068","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 : 2020-12-01DOI: 10.56964/pidspj20202102004
Marimel R. Pagcatipunan, Servando Halili Jr., R. Arciaga, Sarah Makalinaw, Marshall Gonzales, Robert Garcia, Cynthia Aguirre, A. Ong-Lim, Imelda Luna, E. Gallardo, Jonathan Lim, Delta Aguilar, Nicole Pererras
Background: Antimicrobials are drugs that are often misused and inappropriate antimicrobial prescribing often results in poor clinical outcome and drug resistance. Monitoring and regulation of antimicrobial use is currently being done by the Department of Health through the Antimicrobial Stewardship (AMS) Program. There is a need to determine the factors that affect successful implementation of an AMS program in private hospitals in the Philippines. This study was conducted to identify the enablers and potential barriers in implementing an AMS program in nine (9) private hospitals. Methodology: A concurrent mixed methods design was used to assess various stakeholders’ (physicians, administrators, other AMS members) perceptions of existing or proposed AMS programs, and to identify barriers and enablers in their implementation. Quantitative data were collected using self-administered survey questionnaire to assess clinician’s acceptance of AMS programs. Qualitative data were collected through semi-structured one-on-one interviews of clinicians and other AMS personnel and focus group discussions (FGD) of selected clinician groups. Data were gathered from October 2018 to October 2019. Results: 409 clinicians were surveyed, 52 were interviewed and 46 sat for 13 sessions of FGDs. Overall, the survey established that physicians were well aware of antimicrobial resistance problem. Majority of the clinicians indicated general agreement with the currently practiced antimicrobial protocols in their hospitals and with the AMS program. However, there were disagreements in perceptions with how antimicrobial restrictions impair prescribing practices and overuse of the same. These responses were strong points of discussion during the Key Informant Interviews (KII) and FGDs. All respondents were amenable with the institutionalization of an AMS program in their hospitals. The hospital leadership’s commitment was determined to be the key enabler of a successful AMS program’s implementation. Barriers identified for hospitals with existing AMS programs were: lack of dedicated staff, resistance and/or non-cooperation of physicians, lack of support from non-medical departments, and inadequate cooperation between hospital personnel. Barriers identified, regardless of the status of the AMS programs were: deficiency in knowledge with developing and implementing an AMS program, inadequate information dissemination, unavailability of an IT-based monitoring for antibiotic use, and the influence of pharmaceutical companies on stakeholders with regards to antimicrobial use. Conclusion: Similar enablers and barriers to a successful implementation of an AMS program were seen in the different hospitals. A hospital leadership’s commitment was determined to be the key enabler. The success or failure of any AMS program appears to depend on physician understanding, commitment and support for such a program. By involving the main players in an AMS program- the hospital administrators,
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