Year

1996 1997 | 1998 | 1999 | 2001 | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | 2020 | 2021 | 2022

2019 Journals

Journal 2019 Vol.20 No.1
Date of Publication : July 31,2019
Editorial
Of Hurdles, Battles, and The Art of War
Carmina A. delos Reyes, M.D.

This issue marks our first for 2019. A bit way past our target date but worth the wait. There were many hurdles to contend with as with previous issues. There were limited manuscript submissions, limited time, limited budget, limited manpower. Only the hurdle list is limitless and goes on and on.
| View Full Article in PDF format |

Journal 2019 Vol.20 No.1
Effectiveness of Digital Media Technology-based Interventions on HIV STI Risk Reduction Among Young People: A Meta-Analysis
Paul Sherwin O. Tarnate, M.D., Keith Roger R. Serrano, RN, Vanessa-Maria F. Torres-Ticzon, M.D. & Kathlynne Anne A. Senen, M.D.

Abstract
Background: Prevention strategies delivered through digital media technology (DMT) have been developed to reduce HIV incidence among young people. However, no best-practice DMT intervention strategies exist in handling HIV prevention programs among young people.
Objectives: To determine the effectiveness of DMT-based interventions in reducing risk-taking behaviours among young people that may predispose them to acquiring HIV and other sexually transmitted infections.
Subjects and Selection Criteria: Randomized controlled trials and quasi-experimental studies with rigorous controls comparing DMT-based interventions and controls on reducing risk-taking behaviors among young people aged 10-24 years were included. Data Collection: Search methods were done on the following:MEDLINE, CENTRAL, Trials Register, Google Scholar, ScienceDirect, TRIP database, HERDIN, reference lists, & local databases until December 2017.
Analysis: Statistical analysis was done using Review Manager Version 5.3, heterogeneity examined, and analyses done under random effects model. Condom use, sexual behavior, number of sexual partners, STI testing, and sexual health knowledge in standardized effect sizes were calculated with 95% confidence intervals. Data were analyzed in subgroups: Didactics, Modules, Virtual decision-making.
Main Results: Identified sixteenstudies with 7925 subjects comparing DMT interventions and controls. DMT interventions significantly increased condom use (d=0.29, 95% CI 0.18-0.41; p<0.00001), particularly in Didacticssubgroup; and decreased frequency of sexual behavior (d=0.16, 95% CI 0.06-0.26; p=0.002), particularly in Virtual decision-making subgroup.Data significant but heterogeneous for improved sexual health knowledge.There was no statistical difference for decreased number of sexual partners and STI testing.
Conclusions: DMT-based interventions on condom use and frequency of sexual behavior were noted to be effective in reducing risk-taking behaviors among young people.These findings can be appropriately adapted for use in HIV/STI prevention campaigns.
Keywords: Digital media, HIV, STI, Adolescents
| View Full Article in PDF format |

Journal 2019 Vol.20 No.1
Effectiveness of Daily Chlorhexidine Bathing in Reducing HealthcareAssociated Infections in the Pediatric Intensive Care Unit of a Tertiary Government Hospital
Abigail C. Rivera, M.D., Anna Lisa T. Ong-Lim, M.D. & Ma. Liza Antoinette M. Gonzales,M.D.

Abstract
Introduction:
Healthcare-associated infections (HCAIs) are a common complication of prolonged hospital stay, leading to increased morbidity and mortality. This study
aims to determine the effectiveness of daily chlorhexidine bathing in reducing HCAIs in the pediatric intensive care unit (PICU).
Methodology: This is a randomized controlled, observer-blinded study conducted over a 6-month period. Included were 2 months to 18-year-old patients admitted to the PICU, randomly assigned to daily bathing with 2% chlorhexidine or to the standard practice of bathing with plain soap and water. Primary outcome was the incidence of HCAI in each group.
Results: A total of 50 patients were enrolled in the study. Overall incidence of HCAI was lower in the chlorhexidine group compared to the control group (12% versus 36%, RR=0.33, 95% CI 0.10 – 1.09, p=0.047). Incidence density rate was lower in the chlorhexidine group (5.91 versus 21.03 infections per 1000 person-days, p=0.049). Ventilator-associated pneumonia and bloodstream infections were lower in the chlorhexidine group, but results were not statistically significant. There were no significant differences in mortality rates and length of hospital stay. One adverse event of transient rash occurred in the chlorhexidine group.
Conclusion: Daily chlorhexidine bathing may be more effective in reducing HCAIs in the PICU compared to standard care.
Keywords: Chlorhexidine,healthcare-associated infection,pediatric intensive care unit
| View Full Article in PDF format |

Journal 2019 Vol.20 No.1
Comparison of Various Methods of Detection of Hypoxemia and Correlation of Hypoxemia with Clinical Features among Pediatric Patients 3 Months to 5 Years Old with Community-Acquired Pneumonia at a Tertiary Hospital Emergency Room
Francesca Mae T. Pantig, M.D., & Salvacion R. Gatchalian, M.D.,FPPS,FPIDSP,FPSMID
Abstract
Introduction:
Pulse oximetry is frequently utilized as a rapid, non-invasive, point-of-care alternative to arterial blood gas analysis in measuring oxygen saturation of children with pneumonia. Objectives: To compare portable fingertip pulse oximetry saturation (SpO2PF), handheld pulse oximetry saturation (SpO2H) and arterial oxygen saturation (SaO2) in detection of hypoxemia, and correlate hypoxemia with clinical features in children with pneumonia.
Methodology: This was a prospective, observational, cross-sectional study involving patients 3 months to 5 years old with pneumonia. Oxygen saturation was measured using a portable fingertip pulse oximeter, a handheld pulse oximeter, and arterial blood gas analysis.
Results: Eighty-six children were included. SpO2 PF underestimated oxygen levels by 0.126% (95% CI -0.240 to 0.491), while SpO2H underestimated it by 0.323% (95% CI -0.075 to 0.721). Between portable and handheld readings, the mean difference was 0.198% (95% CI -0.089 to 0.484). Across the three methods, limits of agreement ranged from -3.388 to +4.035%. There was no statistically significant difference in variance among the three measurements. Children with tachypnea (cOR 2.623, 95% CI 1.06 – 6.48, p = 0.037), difficulty breathing (cOR 6.316, 95% CI 1.96 – 20.34, p = 0.002), and subcostal retractions (cOR 2.842, 95% CI 1.05 to 7.69, p = 0.040) were more likely to have hypoxemia.
Conclusion: Pulse oximetry closely correlates with arterial blood gas analysis within acceptable limits of agreement and with no significant differences in variance among measurements. Difficulty breathing, tachypnea and subcostal retractions were significantly more likely to be observed in hypoxemic children.
Keywords: community-acquired pneumonia; pulse oximetry; hypoxemia
| View Full Article in PDF format |

Journal 2019 Vol.20 No.1
Duration of Preterm Premature Rupture of Membranes as Predictor of Histologic Chorioamnionitis and Early Onset Neonatal Sepsis: A Cohort Study
Sheryl R. Del Rosario-Famadico, M.D., Ma. Esterlita V.Uy, M.D. & John Anthony Tindoc, M.D.
Abstract
Background:
Preterm premature rupture of membranes (PPROM) has been associated with chorioamnionitis but studies are inconsistent on the relationship between PPROM latency and the risk of chorioamnionitis and early onset sepsis.
Objective: To define the association of PPROM latency and the risk of histologic chorioamnionitis (HCA) and early onset neonatal sepsis (EONS).
Methodology: A prospective cohort study was done at a public tertiary hospital on 569 mothers with spontaneous rupture of membranes and with fetuses EONS was defined using test of association and Receiver Operating Characteristics (ROC) curve analysis. The association of HCA with maternal and neonatal characteristics as well as adverse neonatal outcomes were also determined.
Results: A total of 569 mothers with PPROM were included. Incidence of HCA and EONS were 13% and 24% respectively. PPROM latency was significantly associated with HCA and is a fair predictor of HCA (AUC = 0.7013; 76% accuracy at 31.5-hour cut-off) but failed as a predictor of EONS (AUC = 0.4799). PPROM, platelet count, CRP, and neutrophil count were ndependent predictors of HCA. HCA was associated with EONS and mortality. Mortality was higher in the presence of both HCA and EONS.
Conclusion: Longer PPROM is associated with HCA and is a fair predictor of HCA at a cut-off of 31.5 hours. PPROM fails as a predictor of EONS.
Keywords: preterm premature rupture of membranes, histologic chorioamnionitis, early onset neonatal sepsis, latency period
| View Full Article in PDF format |

Journal 2019 Vol.20 No.1
Clinico-Epidemiologic Profile and Outcome of Pediatric Patients with Multi Drug Resistant Gram-Negative Healthcare Associated Infections at the Philippine General Hospital
Leslie Anne C. Dela Cruz, M.D. & Anna Lisa Ong-Lim, M.D.
Abstract
Introduction:
Multi Drug Resistant Organisms (MDRO) are microorganisms that are resistant to one or more classes of antimicrobial agents, and these have become significant pathogens to contend with in the treatment of Healthcare Associated Infections.
Objectives: This study aimed to determine the clinico-epidemiologic profile
and outcome of pediatric patients with healthcare-associated multi-drug resistant gram-negative infections, and its antimicrobial susceptibility patterns.
Methodology: This was a retrospective study done on pediatric patients with gram negative healthcare associated MDRO sepsis compared to non-MDRO sepsis admitted at the ICU and pediatric wards of a tertiary government hospital from July 2015 to June 2016. Descriptive statistics was used to summarize the clinical characteristics of patients. Odds ratio and the corresponding 95% confidence interval from binary logistic regression was computed to determine significant predictors for the development of multi drug resistance. Outcome of patients with MDRO gram-negative infection was noted, as well as its antimicrobial susceptibility patterns.
Results: A total of 199 patients developed HAI, and 41% were identified to be gram negative MDR cases. Pediatric patients with healthcare associated infections due to MDR gram negative organisms had shorter hospital stay and a higher mortality rate of 78% compared to 41% among non MDR patients.The most commonly isolated gram negative organisms were Burkholderia cepacia, 38%; Klebsiella pneumoniae, 31%; and Acinetobacter baumanii, 18%; while the most common MDR gram negative isolates were Klebsiella pneumoniae, 65%; Acinetobacter aumanii, 22%; and Pseudomonas aeruginosa, 7%. Significant predictors for MDRO were age (0-28 days old), ICU admission, intravascular catheterization and use of total parenteral nutrition.
Conclusion: Profile of pediatric patients with healthcare-associated multidrug resistant gram-negative infections were neonates admitted in the ICU with a shorter hospital stay and a high mortality rate. The identified risk factors for developing Multi Drug Resistant Gram Negative sepsis were age of 0-28 days, admission to ICU, intravascular catheterization and parenteral nutrition. Patients with gram-negative MDR infections have a high mortality rate and
isolates are susceptible mostly to Colistin.
Keywords: multiple drug resistance, healthcare associated infections, gram negative bacterial infections
| View Full Article in PDF format |

Journal 2019 Vol.20 No.1
Epidemiology and Outcome of Children Living with HIV in a Tertiary Hospital: A 6-Year Retrospective Study
Mary Crist A. Delos Santos-Jamora, M.D. & Marimel R. Pagcatipunan, M.D.
Abstract
Introduction:
Infection with HIV is multi-faceted and involves the interplay of medical, social, and economic factors thus, management of the disease continues to be a challenge to
most physicians. The Philippines is experiencing a surge in cases since 2013. Understanding the local epidemiology of pediatric HIV may reveal opportunities to reduce or eliminate transmission through timely diagnosis.
Objective: This study was conducted to identify the features and outcome of children living with HIV in a hospital where a program for HIV treatment and monitoring was implemented.
Methodology: Medical records of all children Guidance Intervention Prevention (SAGIP) Unit were reviewed. Data was analysed using descriptive statistics.
Results: Thirty pediatric HIV patients were included in the study. The most common mode of acquisition is by sexual transmission (57%) and most patients were male (76%),bisexual (47%), and heterosexual (47%). Weight loss (50%),rash (50%), fever (37%) and cough (37%) were the most common clinical findings. The most common opportunistic infections were tuberculosis (47%) and oral candidiasis (34%). Only 27 of 30 patients were started on antiretroviral therapy within 6 months from diagnosis. One patient showed resistance to a non-nucleoside reverse transcriptase inhibitor (NNRTI).
There were 11 children who died of various opportunistic infections and its complications, while 2 were transferred to a different treatment hub after 6 months, and 1 lost to follow-up.
Conclusion: Sexual means of HIV transmission among adolescents is evident in this study. Weight loss, cough, rash, fever, and lymphadenopathy are common presenting features.
Tuberculosis and oral candidiasis are the most common opportunistic infections and should alert physicians on possible HIV infection. A mortality rate of 37% was noted mostly in the first 6 months of initiating ART treatment.
Keywords: Pediatric HIV, Outcome, Profiles
| View Full Article in PDF format |

Bulletin
Dengue Disease Bulletin A Disease Awareness Campaign for Pediatricians
| View Full Article in PDF format |

A Position Statement from the Philippine Pediatric Society and Pediatric
Infectious Disease Society of the Philippines on the Dengue Vaccine
| View Full Article in PDF format |

 

 

Journal 2019 Vol.20 No.2
Editorial
Big Bang
Arlene Dy-Co, M.D.
We hope to end the year 2019 with a big bang by coming out with this issue to keep our journal on track with our releases. Indeed, a big bang as each issue comes out from nothing and the forces joined and stars aligned that we are now coming out with an issue with several original articles, a case series and a feature article.
| View Full Article in PDF format |

Feature Articles

Vaccine Trust as a Public Trust
John Andrew Camposano, M.D.
In September 2019, the Department of Health declared a polio outbreak after two cases of the paralyzing disease were confirmed in the country. After outbreaks of measles and dengue in the same year, another outbreak of a vaccine-preventable disease has once again put into sharp focus the declining vaccination rates in the Philippines. Declining rates of vaccination have already been a problem in the country, but this has been exacerbated by the Dengvaxia controversy that further pushed the vaccination rates down. The reemergence of polio, after being a polio-free country for 19 years, presents another opportunity to address issues in vaccine trust.
| View Full Article in PDF format |

Original Articles
Journal 2019 Vol.20 No.2

The Clinical Profile and Outcome of Children with Dengue Encephalitis at the Philippine Children’s Medical Center: A Retrospective Study From January 2011-June 2017
Kristine Alvarado-Dela Cruz, M.D., Madelyn P. Pascual, M.D. & Maria Eva Luna- Dizon, M.D.
Abstract
Background:
Dengue, a mosquito-borne flavivirus, is hyperendemic in the Philippines. One of its rare complication is dengue encephalitis, characterized by altered sensorium, elevated liver enzymes, and high dengue-specific antibody titers. Previously known as non-neurotropic, dengue presents with an increasing incidence of neurologic manifestations.
Objective: To describe the clinico-demographic profile and outcome of laboratory-confirmed dengue encephalitis patients.
Methods: This is a retrospective study that used purposive sampling to describe laboratory-confirmed dengue encephalitis cases aged 0-18 years. The clinico-demographic profiles and outcomes were collected using chart review, and variables were analyzed using descriptive statistics.
Results: 14 laboratory-confirmed cases were reviewed. Most (57%) were males aged 3 days-15 years. Fever lasted 3-11 days. Following nonspecific signs and symptoms, neurological manifestations developed within 1-5 days, the most common being seizures (71%). Majority (57%) had anemia. All, except one, exhibited leukopenia and thrombocytopenia. Elevated liver enzymes, bleeding parameter derangements, electrolyte, and glucose imbalances were noted. All were seropositive for dengue IgM, and 5 dengue IgM in the CSF. Most common EEG findings showed generalized slowing. Neuroimaging reports were normal in some or showed cerebral edema in the others. Half of the patients recovered fully, 3 showing partial recovery from neurologic changes, and 3 others had neurologic sequelae. One infant expired.
Conclusions and Recommendations:
Dengue encephalitis should be considered in patients living in an endemic country, presenting with fever with neurologic changes or elevated liver enzymes, with a risk for developing neurologic sequelae or death.
Keywords: Dengue Encephalitis, Neurotropic virus, Severe Dengue
| View Full Article in PDF format |

Journal 2019 Vol.20 No.2

The Antibiogram of Isolated Pathogens from Tracheal Aspirate among Intubated Patients 2 Months – 5 Years Old with very Severe Community Acquired Pneumonia Admitted in Pediatric Intensive Care Unit of a Tertiary Hospital in Cebu City from 2013-2016
Glaiza S. Dagani, M.D., Dahlia L. Yu, M.D., Shanida L. Camomot, M.D. & Elmer Kent A. Lopez, M.D.
Abstract
Objective
: To determine the antibiogram of tracheal aspirate cultures (TACS) among intubated children aged 2 months to 5 years old with very severe community acquired pneumonia (CAP).
Methodology: A retrospective chart review using total enumerative sampling.
Results: 66 out of the 343 patients had positive TACS. The top 5 most common isolates were Klebsiella pneumoniae(37.8%), Pseudomonas aeruginosa (25.7%), Acinetobacter baumanii (15.1%), Enterobacter cloacae (12.1%) and Methicillin Resistant Staphylococcus aureus (MRSA) (6%). The gram-negative isolates were highly sensitive to amikacin and carbapenems. Majority of these patients (92.42%) had history of Pentavalent immunization. Majority of patients who were TACS positive had history of antibiotic use prior to admission (92.42%), mostly second-generation cepahalosporin (cefuroxime, 32.42%). High rates of resistance to ampicillin and gentamicin were noted for patients with Klebsiella pneumoniae and Enterobacter cloacae isolates. Majority of patients with Klebsiella pneumoniae, Acinetobacter baumanii and MRSA expired.
Conclusion/Recommendation: Majority of those patients with positive isolates had MDR organisms thus for patients with very severe CAP who already received antibiotic as outpatient, broad spectrum antibiotics should be considered as empiric therapy and TACS be done on all patients with very severe CAP.
Keyords: Pneumonia very severe, Multi-drug resistant organisms, Tracheal aspirate culture
| View Full Article in PDF format |

Journal 2019 Vol.20 No.2

Childhood Meningitis in an Urban Tertiary Medical Center: A 20-year Review
Angelina B. Calderon, M.D. & Robert Dennis Garcia, M.D.
Abstract
Background
: Meningitis is a neurological emergency causing significant morbidity and mortality. This research determined the etiologies, clinical presentation, and ancillary work-up findings of different types of meningitis.
Objective: To characterize the documented pediatric meningitis cases in a tertiary hospital admitted between January 1, 1997 to August 31, 2017.
Methods: This was a retrospective study which entailed review of charts of all pediatric cases 0 to 18 years old with a discharge diagnosis of meningitis (bacterial, viral, tuberculous or fungal) from January 1, 1997 to August 31, 2017 at an urban tertiary medical center.
Results: This study included 127 subjects, where 74 (58.3%) had bacterial, 34 (26.8%) had viral, 17 (13.4%) had tuberculous, and 2 (1.6%) had fungal meningitis. Streptococcus pneumoniae (12.2%), Haemophilus influenzae type b (6.8%) and Salmonella enteritidis (6.8%) were the top bacteria identified. Neonatal infections were caused by gram-negative bacilli (66.7%) and gram-positive cocci (33.3%). Bacterial, tuberculous, and viral meningitis were seen in the 1-11 months, 2-4 years and 5-10-year age groups respectively. Prolonged fever (mean 27.2, median 14 days) and cranial nerve palsies (23.5%) were noted in tuberculous meningitis (TBM). The highest CSF mean WBC (2043±9056 WBC/µL) and mean protein (300±365.6mg/dL) were seen in bacterial and tuberculous meningitis respectively. The combination of hydrocephalus, basal enhancement and infarct was unique to patients with tuberculous meningitis. Recurrent seizures were the most common complication of bacterial (36.5%), viral (20.6%) and tuberculous (100%) meningitis. Ceftriaxone (24.3%), acyclovir (38.2%), and isoniazid/rifampicin/pyrazinamide/ethambutol (76.5%) were the most common antimicrobials for bacterial, viral, and tuberculous meningitis. Fever duration before admission was significantly longer in TBM (14 days) than in viral (4 days) and bacterial meningitis (2 days). Length of hospital stay for viral meningitis (6.5 days) was significantly shorter than for TB (14 days) and bacterial meningitis (12 days). Mortality rates were 12% and 11% for bacterial and viral meningitis respectively. No mortality was seen in patients with TB and fungal meningitis.
Conclusions: In this 20-year review of childhood meningitis, bacterial meningitis was the most common type of pediatric meningitis which presented with marked CSF pleoctyosis. The longest fever duration and the highest proportion of cranial nerve involvement were seen in TBM, which also had the unique combined findings of leptomeningeal enhancement, hydrocephalus and infarct on imaging. Ceftriaxone was the most commonly used antibiotic for bacterial meningitis, except in neonates where a combination of cefuroxime-amikacin was initially given until microbiological confirmation became available. Recurrent seizures were the most common complication of bacterial, viral and TB meningitis. The shortest hospital stay with the highest full recovery rate was seen in viral meningitis.
Keywords: meningitis, clinical manifestations, ancillary findings, treatment, outcomes
| View Full Article in PDF format |

Journal 2019 Vol.20 No.2

Clinical Profile, Microbiology, Management, and Outcome of Pediatric Brain Abscess at the University of the Philippines- Philippine General Hospital: A 5-year Retrospective Study (2012-2016)
Carla Maja Lizl A. Montaña, M.D., Anna Lisa T. Ong-Lim, M.D. & John Andrew T. Camposano, M.D.
Abstract
Objective
: To determine the clinical profile, microbiology, management, and outcome of pediatric brain abscess at a tertiary hospital in the Philippines from 2012 to 2016.
Methods: A retrospective study and review of medical records of 50 patients aged 18 years old and below diagnosed with brain abscess from 2012 to 2016 was performed.
Results: Majority of patients affected were 10 years old and below (74%), with no gender predilection, and mostly underweight/wasted (68%). Coverage for common vaccine-preventable pathogens was low (38% for H. influenzae type b, 2% for S. pneumoniae). Most common signs and symptoms on admission were fever (62%), vomiting (50%), and headache (50%). The top pre-disposing condition was congenital heart disease (46%), mostly Tetralogy of Fallot (33%). Methicillin-resistant Staphylococcus aureus (MRSA) was isolated in 38%) of cases. Sterile cultures comprised 68% of cases. There were two cases of tuberculous abscess. Empiric antibiotics administered for patients seen in 2012 were penicillin G and chloramphenicol, with a shift to a third-generation cephalosporin and metronidazole in the succeeding years. Aspiration with or without drainage was performed in majority of cases (85%). Six underwent complete excision and had a shorter mean length of stay of 57 days, and a lower morbidity rate of 17% with no mortalities. The overall mean length of hospital stay was 65 days. Residual neurologic deficit was observed in 28%, mostly extremity weakness. Mortality rate was 6.8%. No statistical association was found between a predisposing condition and affectation of a particular area of the brain using the Fisher exact test.
Conclusion: There should be a high index of suspicion for brain abscess among patients with pre-disposing conditions (i.e. paracranial infection, cyanotic congenital heart disease) presenting with fever, headache, and vomiting. Common etiologic agents in this study were MRSA and Enterococcus. The isolates were sensitive to the antibiotics recommended for empiric therapy, particularly parenteral third generation cephalosporin + metronidazole for 6 to 8 weeks. Patients with sterile cultures were also continued on this regimen. With the high resistance rates to oxacillin, vancomycin should be considered for abscesses arising from paracranial infections and for those with breaks in the skull post-trauma. There was an overall reduction in mortality due to improved imaging studies andidentification of pathogens for definitive treatment, as well as improved surgical techniques over time. A considerable number of affected children however had neurologic deficits upon discharge.
Keywords: Pediatric brain abscess
| View Full Article in PDF format |

Journal 2019 Vol.20 No.2

Case Series
Intraventricular Antimicrobial Therapy in Children with Multi-Drug Resistant Ventriculitis: A Tertiary Hospital Experience and Literature Review
Francesca Mae T. Pantig, M.D. & Anna Lisa T. Ong-Lim, M.D.
Abstract
Background
: Intraventricular antimicrobial therapy (IVT), defined as the direct installation of antimicrobial agents into the lateral ventricles has been utilized as the last therapeutic option for the treatment of multidrug-resistant ventriculitis. The aim of this case series is to report our institution’s experience with IVT in pediatric patients with ventriculitis.
Material and Methods: Retrospective chart review was done. The demographic data, cerebrospinal fluid (CSF) culture isolates, treatment regimens, and clinical outcomes of these patients were collected and described.
Results: Between 2016 to 2018, seven (7) pediatric patients diagnosed with ventriculitis caused by multidrug-resistant organisms underwent intraventricular antimicrobial therapy in combination with intravenous therapy. The median age was 1 year (range 1 month to 17 years old, mean: 4.4 years). Fifty-seven (57) percent of the patients were females. The isolated pathogens were Acinetobacter baumannii MDRO (n = 3), Klebsiella pneumoniae MDRO (n = 2), Methicillin-resistant Staphylococcus aureus (n = 1), and Methicillin-resistant Staphylococcus epidermidis (n = 2).One patient had mixed isolates on CSF culture (Acinetobacter baumannii and MRSE). The antimicrobial agents for IVT used were colistin (n = 4), vancomycin (n = 2), and gentamicin (n = 1). The mean time to initiation of intraventricular therapy from the diagnosis of ventriculitis was 19 days. The mean duration of IVT therapy was 15 days. The survival rate was 57%.
Conclusion: Ventriculitis caused by drug-resistant organisms is an emerging concern. Optimal therapy is not yet established and experience with IVT is limited. This series showed that there were no adverse effects related to IVT thus it may be considered an option for MDRO ventriculitis. Gram negative organisms are more common causes of ventriculitis in our institution.
Keywords: intraventricular IVT, ventriculitis, multidrug-resistant organism MDRO
| View Full Article in PDF format |

Year

1996 | 1997 | 1998 | 1999 | 2001 | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | 2020 | 2021 | 2022   

EDITOR-IN-CHIEF:
Carmina delos Reyes, M.D.
Arlene Dy-Co, M.D.

EDITORIAL BOARD:
Mary Ann Bunyi, M.D.
John Andrew Camposano, M.D.
Mary Antoinette Cuady-Madrid, M.D.
Xenia Catherine Fabay, M.D.
Elizabeth Gallardo, M.D.
Fatima Gimenez, M.D.
Jonathan Lim, M.D.
Sarah Makalinaw, M.D.
Francesca Mae Pantig, M.D.
Paul Sherwin Tarnate, M.D.

ADVISERS:
Cecilia Maramba-Lazarte, M.D., MScID, MScCT

JOURNAL MANAGER:
Patricia Navarro-Parlade, M.D.