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Infection Control and Prevention of COVID-19 Transmission: Interim Recommendations for Schools in the Philippine Setting (as of August 6, 2020) 感染控制和预防COVID-19传播:对菲律宾学校的临时建议(截至2020年8月6日)
Pub Date : 2020-12-01 DOI: 10.56964/pidspj20202102010
J. Camposano, Sally Jane Aro, B. Co, Robert Garcia, Maria Angela Maronilla, Maria Carmen Nievera, Jay Ron Padua
THIS GUIDANCE AIMS TO SUPPORT PHYSICIANS WHO COLLABORATE WITH SCHOOLS AND GOVERNMENT IN CREATING INFECTION CONTROL POLICIES FOR SCHOOL RE-ENTRY IN THE TIME OF COVID-19 PANDEMIC, WHILE TAKING INTO CONSIDERATION THE OVER-ALL HEALTH OF EVERYONE, BASED ON AVAILABLE EVIDENCE. THE GUIDANCE IS DYNAMIC AND MAY CHANGE DEPENDING ON THE RAPIDLY EVOLVING KNOWLEDGE, DATA, AND UNDERSTANDING OF SARS-COV-2 IN THE COUNTRY.
本指南旨在支持医生与学校和政府合作,在COVID-19大流行期间制定感染控制政策,同时根据现有证据考虑到每个人的整体健康。该指南是动态的,并可能根据该国对sars-cov-2的快速发展的知识、数据和理解而变化。
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引用次数: 0
Interim Guidelines on the Screening, Assessment and Clinical Management of Pediatric Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) 小儿疑似或确诊冠状病毒病2019 (COVID-19)筛查、评估和临床管理暂行指南
Pub Date : 2020-12-01 DOI: 10.56964/pidspj2021220112
J. Camposano, A. Ong-Lim, Francesca Mae T. Pantig, Paul Sherwin Tarnate, Cecilia Maramba-Lazarte, Lesley Anne Dela Cruz, Imelda Luna, Jay Ron Padua, Abigail Ruiz Rivera, Ma. Kristina Ulob-Torio, Marshall Gonzales
The emergence of the novel coronavirus SARSCoV-2 and the subsequent declaration by the World Health Organization of the coronavirus disease 2019 (COVID-19) pandemic has greatly impacted the lives of many all over the world. As the total number of reported cases increase globally, the number of pediatric cases have also steadily increased over the past several months. This has led to an expansion of scientific and clinical knowledge on COVID-19 in children.
新型冠状病毒SARSCoV-2的出现以及随后世界卫生组织宣布2019冠状病毒病(COVID-19)大流行,极大地影响了世界各地许多人的生活。随着全球报告病例总数的增加,儿科病例数在过去几个月中也在稳步增加。这扩大了关于儿童COVID-19的科学和临床知识。
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引用次数: 0
Scenarios After Enhanced Community Quarantine for COVID 19 Pandemic in the Philippines…What Can We Do as Filipinos 菲律宾COVID - 19大流行加强社区隔离后的情景……作为菲律宾人,我们能做些什么
Pub Date : 2020-06-01 DOI: 10.56964/pidspj20202101002
Robert Garcia
To date, the Philippine lockdown has been successful. The country had a cumulative total of 9,223 cases, with 295 new ones, on May 3, 20201 while the U.S.A. had 1,133,069 cases and 30,000 new cases/day on May 1, 2020.2 As the American lockdown was not uniformly done across the 50 states, the U.S. has done disproportionately much worse than the Philippines, considering that the former’s population is only three times that of ours. Indeed, our 200-300 new cases per day, for a country of 110 million, is low; we cannot realistically achieve an actual figure of zero.
到目前为止,菲律宾的封锁是成功的。今年5月3日,菲律宾累计确诊病例9223例,新增确诊病例295例,而美国5月1日确诊病例1133069例,新增确诊病例3万例/日。由于美国50个州的封锁措施并不统一,人口仅为菲律宾的3倍,美国的情况比菲律宾严重得多。事实上,对于一个拥有1.1亿人口的国家来说,我们每天2 -300例新病例的数量很低;我们不可能实际得到零的数字。
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引用次数: 0
To Ponder Amidst the Pandemic 大流行中的思考
Pub Date : 2020-06-01 DOI: 10.56964/pidspj20202101001
Carmina Delos Reyes
Who would have thought that amidst the new year revelries last December, in Wuhan China, a different kind of explosion surfaced, which we now know as COVID-19. A month later, on 30 January 2020, the outbreak was declared a Public Health Emergency of International Concern. As history unfolds, we find ourselves each day seeking new information to cope with this pandemic.
谁能想到,在去年12月的新年狂欢中,中国武汉出现了一种不同的爆发,我们现在称之为COVID-19。一个月后,即2020年1月30日,疫情被宣布为国际关注的突发公共卫生事件。随着历史的发展,我们发现自己每天都在寻求新的信息来应对这一流行病。
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引用次数: 0
Clinical Profile and Outcome of Admitted Pediatric Patients with Influenza 住院儿科流感患者的临床概况和预后
Pub Date : 2020-06-01 DOI: 10.56964/pidspj20202101007
Nicole M Reyes, J. Navoa-Ng, Roland Dela Eva
Background: Influenza is one of the most common illnesses pediatricians face. Children are especially at risk for contracting influenza. Aside from fever, cough and colds, the disease may present differently in children. Complications due to influenza are varied and anti-virals may be useful if given early in the course of illness. Objectives: To determine the clinical profile of admitted pediatric patients with influenza based on rapid testing and determine its prevalence, outcome and complications. Methods: Cross sectional study of pediatric patients who had nasopharyngeal swab for influenza by antigen rapid detection test were included. Retrospective chart review was done on patients with influenza-like illness admitted from 2013-2019. Results: There were 244 patient charts reviewed, the mean age of patients was 5 – 9 years old and majority had no influenza vaccine during the year of admission. Patients presented with fever, cough, colds and non-specific symptoms. Ear pain, difficulty of breathing and myalgia were found to be associated with a positive influenza infection. Of the 244 suspected patients, 133 (54%) were positive for influenza rapid testing, 33% were influenza B positive and 21.3 % were influenza A positive. The most common clinical complication for influenza positive patients was pneumonia. 1 patient had respiratory failure, 5 had febrile convulsions and 7 developed viral myositis. 19% of the subjects had asthma as co-morbidity. Only 11% of the population had their annual influenza vaccine. Conclusion: 54% of pediatric patients tested for influenza had positive tests for either Influenza A or B. Although generally a mild illness, it contributes to morbidity and mortality in children. Complications are not uncommon in the pediatric population as seen in this study. Vaccination remains an important preventive measure to curb influenza cases.
背景:流感是儿科医生面临的最常见疾病之一。儿童尤其容易感染流感。除了发烧、咳嗽和感冒外,这种疾病在儿童身上的表现可能有所不同。流感引起的并发症多种多样,如果在发病早期给予抗病毒药物可能是有用的。目的:基于快速检测确定住院儿科流感患者的临床概况,并确定其患病率、预后和并发症。方法:采用横断面研究方法,对经鼻咽拭子进行流感抗原快速检测的患儿进行分析。对2013-2019年入院的流感样疾病患者进行回顾性图表回顾。结果:244例患者的平均年龄为5 ~ 9岁,大多数患者入院时未接种流感疫苗。患者表现为发热、咳嗽、感冒和非特异性症状。耳痛、呼吸困难和肌痛被发现与流感阳性感染有关。244例疑似患者中,流感快速检测阳性133例(54%),乙型流感阳性33%,甲型流感阳性21.3%。流感阳性患者最常见的临床并发症是肺炎。1例出现呼吸衰竭,5例出现热性惊厥,7例出现病毒性肌炎。19%的受试者合并哮喘。只有11%的人口每年接种流感疫苗。结论:54%接受流感检测的儿科患者对甲型或乙型流感检测呈阳性。尽管流感通常是一种轻微疾病,但它会导致儿童的发病率和死亡率。如本研究所见,并发症在儿科人群中并不罕见。疫苗接种仍然是遏制流感病例的重要预防措施。
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引用次数: 1
Utility of Urine KOH in Detecting Candiduria in Infants 尿KOH在婴幼儿念珠菌检测中的应用
Pub Date : 2020-06-01 DOI: 10.56964/pidspj20202101003
Mark Joseph Castellano, M. A. Madrid
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.
背景:念珠菌是需要医疗护理的婴幼儿尿路感染的常见原因。念珠菌真菌成分可以在尿液中用氢氧化钾(KOH)显微镜检查。然而,这些元素的检测并不总是与念珠菌相关。目的:建立尿KOH在鉴别念珠菌病中的作用,确定念珠菌病的危险因素,以及与念珠菌病相关的尿液分析和CBC参数。方法:这项前瞻性横断面研究纳入了1岁及以下的住院婴儿,进行了尿培养,并有任何念珠菌病的危险因素。另外尿液KOH检测采用清洁捕集法或导尿管法。尿液培养作为金标准。结果:在90名同时进行尿培养和尿KOH的研究参与者中,13名(14%)患有念珠菌。留置导尿管的使用、尿路异常、尿分析白细胞酯酶阳性、CBC单核细胞计数增加均与念珠菌有关。尿KOH检测念珠菌的敏感性为100% (CI 75.2 ~ 100%),特异性为59.7% (CI 47.9 ~ 70.7%), PPV为29.5% (CI 17.7 ~ 45.2%), NPV为100% (CI 92.2 ~ 100%)。结论:尿KOH阴性具有良好的阴性预测价值,而尿KOH阳性则值得进一步研究。在开始经验性抗真菌治疗之前,应根据患者的危险因素、临床状态和其他实验室结果谨慎解释尿KOH结果。尿KOH阳性不一定需要治疗。
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引用次数: 0
Interim Guidelines on the Screening, Assessment and Clinical Management of Pediatric Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) Version 2, 12 April 2020 《2019年疑似或确诊冠状病毒病(COVID-19)患儿筛查、评估和临床管理暂行指南(第二版)》,2020年4月12日
Pub Date : 2020-06-01 DOI: 10.56964/pidspj20202101010
Maria Carmen Nievera, A. Ong-Lim, J. Camposano, Marshall Gonzales, Francesca Mae T. Pantig, Paul Sherwin Tarnate, Cecilia Maramba-Lazarte, Lesley Anne Dela Cruz, Jay Ron Padua, Abigail Ruiz Rivera
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引用次数: 0
Development of a Clinical Risk Score to Diagnose Concurrent Bacterial Infections in Children with Dengue 诊断儿童登革热并发细菌感染的临床风险评分的发展
Pub Date : 2020-06-01 DOI: 10.56964/pidspj20202101006
A. F. Santos, Ma. Eva Luna Dizon
Background: The clinical course of dengue can be adversely affected by bacterial coinfection. Because of this, clinical manifestations may be severe and may lead to morbidity and mortality. Little is known about this dual infection in the pediatric population. Objectives: This study was conducted to evaluate the clinical characteristics and risk factors of patients with dengue infection and coinfection and subsequently develop a scoring system to diagnose bacterial coinfection in patients with dengue. Methods: A prospective cross-sectional observational study was conducted among hospitalized pediatric patients with confirmed dengue infection between January 2019 to August 2019. Baseline characteristics, risk factors, clinical parameters, laboratory findings, management and outcomes were recorded. Cases with concurrent bacterial infections were further analyzed. A scoring system was created which assigned 1 point each for the following risk factors -age ≤9 years, fever >5 days, dengue severe, and 2 points for CRP >12 mg/l) Results: A total of 154 pediatric dengue patients were enrolled with a mean age of 8.54 ± 4.15 years, and 99 patients (64%) had bacterial coinfection. Patients with coinfection were A total of 154 pediatric dengue patients were enrolled with a mean age of 8.54 ± 4.15 years, and 99 patients (%) had bacterial co-infection. Patients with coinfection were younger, have prolonged fever (>5 days), and were more frequently observed to have hypotension, tachycardia, desaturations and bleeding. Patients with coinfection also had higher white blood cell counts (>8 x109 cells/L), higher neutrophil counts (58.80 ± 18.42 % count), and elevated CRP (>12 mg/l) and procalcitonin (>4.01 ng/L). Utilizing the scoring system developed, a score of ≥3 had a sensitivity of 66.67% and specificity of 76.36%, in diagnosing concurrent bacterial infection in children with dengue. Conclusions: Patients with dengue and bacterial coinfections were younger with comorbidities. They presented with significantly abnormal vital signs, physical examination findings, and elevated acute phase reactants. Using age ≤ 9 years, fever >5 days, dengue severe, and CRP >12mg/l, a scoring system was developed to diagnose bacterial coinfection in patients with dengue. A score of ≥3 can help diagnose patients with dengue and bacterial coinfection who will most likely need early empiric antimicrobial therapy.
背景:细菌合并感染可对登革热的临床病程产生不利影响。因此,临床表现可能很严重,并可能导致发病率和死亡率。在儿科人群中对这种双重感染知之甚少。目的:本研究旨在评估登革热感染和合并感染患者的临床特征和危险因素,并随后建立一个评分系统来诊断登革热患者的细菌合并感染。方法:对2019年1月至2019年8月确诊登革热感染的住院儿科患者进行前瞻性横断面观察研究。记录基线特征、危险因素、临床参数、实验室结果、管理和结果。并发细菌感染病例进一步分析。建立评分系统,对以下危险因素(年龄≤9岁、发热>5天、登革热重症、CRP >12 mg/l)分别给予1分和2分。结果:共入组154例儿童登革热患者,平均年龄(8.54±4.15)岁,99例(64%)合并细菌感染。共纳入154例小儿登革热患者,平均年龄为8.54±4.15岁,其中99例(%)合并细菌感染。合并感染的患者年龄较小,发热时间延长(>5天),低血压、心动过速、去饱和和出血更为常见。合并感染患者白细胞计数较高(>8 × 109细胞/L),中性粒细胞计数较高(58.80±18.42%计数),CRP升高(>12 mg/ L),降钙素原升高(>4.01 ng/L)。利用所建立的评分系统,得分≥3分诊断登革热患儿并发细菌感染的敏感性为66.67%,特异性为76.36%。结论:登革热和细菌共感染的患者年龄较小,且有合并症。他们表现出明显异常的生命体征、体格检查结果和急性期反应物升高。采用年龄≤9岁、发热>5天、登革热重症、CRP >12mg/l,建立登革热患者细菌合并感染诊断评分系统。得分≥3有助于诊断登革热和细菌合并感染的患者,这些患者很可能需要早期经验性抗菌药物治疗。
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引用次数: 0
Validation of the Filipino Translated Questionnaire on Parent Attitudes About Childhood Vaccines 菲律宾语翻译的父母对儿童疫苗态度问卷的验证
Pub Date : 2020-06-01 DOI: 10.56964/pidspj20202101005
Vincent Albert Flores, Kristine Zillah Arroyo, M. C. Alinea, Lorna R. Abad
Objective: To determine the content validity and test-retest reliability of the Filipino Translated Questionnaire on Parent Attitudes About Childhood Vaccines. Methodology: Eligible parents of patients seen at the Pediatric Outpatient Department, Pediatric Emergency Room and Pediatric Wards of the Philippine General Hospital were recruited into the study. The original survey tool was translated to Filipino by the Sentro ng Wikang Filipino. A focus group of four experts in the field of vaccination rated the content of each item on the questionnaire based on its relevance. Ten Filipino speaking participants were then recruited to check its face validity. This was then implemented to 67 Filipino speaking participants to check its test-retest reliability. Results: The overall item content validity index of the questionnaire was computed to be 0.95. All items had a 100% rating in terms of clarity and simplicity. The high intraclass correlation coefficient of 0.970 supports the tool’s test-retest reliability. However, the test had a low Cronbach’s α coefficient of 0.687 which could be increased to 0.711 with the removal of one item from the question pool. Conclusion: The Filipino Translated Questionnaire on Parent Attitudes About Childhood Vaccines has face and content validity with an acceptable internal consistency. This can serve as a framework for future researches on vaccine hesitancy.
目的:确定菲译《父母对儿童疫苗态度问卷》的内容效度和重测信度。方法:在菲律宾总医院儿科门诊部、儿科急诊室和儿科病房就诊的患者的符合条件的父母被招募到研究中。最初的调查工具由Sentro ng Wikang菲律宾人翻译成菲律宾语。由疫苗接种领域的四名专家组成的焦点小组根据其相关性对问卷上每个项目的内容进行评级。然后招募了10名说菲律宾语的参与者来检查其面部有效性。然后对67名说菲律宾语的参与者实施了这一测试,以检验其重测可靠性。结果:计算出问卷整体项目内容效度指数为0.95。在清晰度和简单性方面,所有项目都获得了100%的评分。0.970的高类内相关系数支持该工具的重测信度。然而,测试的Cronbach 's α系数较低,为0.687,从问题池中删除一个项目可以增加到0.711。结论:菲译《父母对儿童疫苗态度问卷》具有表面效度和内容效度,具有可接受的内部一致性。这可以作为未来疫苗犹豫研究的框架。
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引用次数: 0
Effectiveness and Adverse Effects of Intravenous Colistin In Neonates with Multi-Drug Resistant Gram-Negative Bacterial Infections 静脉注射粘菌素治疗新生儿多重耐药革兰氏阴性菌感染的疗效及不良反应
Pub Date : 2020-06-01 DOI: 10.56964/pidspj20202101004
Michael Crisostomo, Cecilia Maramba-Lazarte
Background: The global burden of multi-drug resistant gram-negative bacterial (MDR-GNB) infections has been increasing. Neonates are at a particularly high-risk and there is limited treatment option. The use of colistin has been re-introduced for this population. However, data on its use in neonates is scarce. Objectives: To determine the effectiveness and adverse effects of intravenous colistin in neonates with multidrug-resistant gram-negative infections. Design: This is a retrospective cohort study of the clinical profile and outcome of neonates with MDR-GNB infections given colistin for a minimum of 3 days conducted from April 2015 to April 2019. Results: A total of 175 pediatric patients had MDR-GNB infections. 75 (43%) neonates met the inclusion criteri a and received intravenous colistin. Of the 75 patients with MDRGNB infections- that included sepsis, pneumonia, urinary tract infection and abscess, 37 (49.3%) were alive and 38 (50.7%) patients died. Nephrotoxicity was seen in 4% if patients and 2.6% patients had hypersensitivity reaction. MDROs isolated were Acinetobacter baumanii, Klebsiella pneumoniae and Pseudomonas aeruginosa. Conclusions: Intravenous colistin is 50% effective and is relatively safe to use in neonates.
背景:多重耐药革兰氏阴性细菌(MDR-GNB)感染的全球负担一直在增加。新生儿的风险特别高,治疗选择有限。对这一人群已重新引入粘菌素。然而,关于其在新生儿中的使用的数据很少。目的:探讨静脉注射粘菌素治疗新生儿多重耐药革兰氏阴性感染的疗效及不良反应。设计:这是一项回顾性队列研究,研究了耐多药- gnb感染的新生儿在2015年4月至2019年4月期间给予至少3天粘菌素的临床概况和结果。结果:共有175例患儿发生耐多药gnb感染。75例(43%)新生儿符合纳入标准a并接受静脉注射粘菌素。在75例MDRGNB感染患者中(包括败血症、肺炎、尿路感染和脓肿),37例(49.3%)存活,38例(50.7%)死亡。4%的患者出现肾毒性,2.6%的患者出现超敏反应。分离到的MDROs有鲍曼不动杆菌、肺炎克雷伯菌和铜绿假单胞菌。结论:新生儿静脉注射粘菌素的有效率为50%,是相对安全的。
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引用次数: 0
期刊
Pediatric Infectious Disease Society of the Philippines Journal
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