Etiology of neonatal sepsis in five urban hospitals in the Philippines

The most frequent cause of mortality in neonates is infections which include sepsis, meningitis, pneumonia, diarrhea and tetanus. Approximately 1.6 million deaths due to neonatal infections occur annually in developing countries. The causes of sepsis vary from one geographic area to another. Thus, it is important to create a database for the Philippines regarding the etiologies of neonatal sepsis. Objectives: The study was undertaken to determine the most common bacterial pathogens of neonatal sepsis in the Philippines and the antibiotic sensitivity patterns of these pathogens. Methods: A multicenter surveillance and chart review was conducted in five hospital sites for a period of six months- from July to December 2006. All neonates less than or equal to 28 days who had positive cultures from a sterile site and or had fulfilled the SIRS criteria as defined by the International Pediatric Sepsis Consensus Conference in the presence of suspected or proven infection were included in the study. Results: A total of 289 neonates fulfilled the criteria of sepsis. More than 61% of the patients had early onset neonatal sepsis. The most common site of infection was the lungs, (57%), followed by sepsis without an obvious site of infection (35%). In 50% of patients, an organism was identified; gram-negative bacteria were the dominant bacteria found (Pseudomonas, Burkholderia, Klebsiella) which comprised 94% of the bacteria isolated. Resistance patterns varied among the different urban study centers. The Pseudomonas and Burkholderia isolates from the Philippine General Hospital (PGH) were sensitive to ceftazidime. All Klebsiella isolates from St. Louis University (SLU) were resistant to third generation cephalosporins. In contrast, Klebsiella isolates from PGH and Davao were sensitive to third generation cephalosporins but resistant to piperacillin-tazobactam. The overall mortality rate was 11%. Ampicillin and an aminoglycoside were the most common regimens used but were only successful in less than 50% of cases. Conclusion: Gram-negative organisms comprised the majority of the neonatal infections, with Pseudomonas and Burkholderia being the most prevalent. Resistance patterns differed among the different centers. Continuing surveillance of infections is still needed in order choose the most appropriate empiric therapy for each center.

Survey on the knowledge, attitutes and practices of parents in Barangay 8A, district 1, Davao City regarding their children's immunization

Background: Despite the success of the Expanded Program of Immunization, many vaccine-preventable diseases remain prevalent in developing countries. Objective: This study aims to determine the knowledge, attitudes, and practices of parents regarding immunization of their children. Methods: This is a descriptive study using a pre-tested, self-administered questionnaire pertaining to knowledge, attitudes, and practices of parents regarding immunization. The questionnaire was given to parents whose children were being immunized at a barangay health center within a one month period. Results: Twenty-nine (93%) out of 31 mothers claimed they knew what vaccines were to be given, but only 22 (75.86%) were correct. Twenty-one (68.75%) learned of the immunization through barangay health workers. With regard to adverse reactions: giving of appropriate medication was applied by 18 (69.2%) respondents. Six mothers (23%) preferred going to a physician; 29 (93.5%) were aware of the next scheduled dates of visit. Major reasons for missed vaccinations were sickness and long waiting time before vaccine was given: accounting for 9 (29.03%) each. During the times when vaccines were not available at the health center, 19 (61.29%) preferred to wait for it to become available. 20 respondents (64.5%) knew of other recommended vaccines which were not included in the EPI (Non-EPI) vaccines, but only 3 (9.7%) availed of it from private physicians. Of this group, 14 (70%) were willing to avail of the vaccines; 17 (85%) were thought of these vaccines as expensive; 12 (71%) were willing to have their children vaccinated; and 3 (17.64%) opted to save money first prior to vaccination. Conclusion: Parents still lacked knowledge with regards to their children's vaccination. The outcome of the child being fully immunized depends on the availability and affordability of vaccine, as well as, the willingness and effort of their parents.