Rapid detection of Respiratory Pathogens using a Multiplex PCR assay among hospitalized children with Acute Respiratory Infection

Background@#Acute respiratory infection (ARI) is a major cause of morbidity and mortality among children worldwide however, local data on the etiologic diagnosis of ARI are limited. @*Objectives@#To determine the prevalence and the most commonly detected respiratory pathogens using a multiplex PCR assay, known as the Respiratory Panel, among hospitalized children with ARI and compare their clinical and laboratory differences. @*Methods@#This is a cross sectional study of children with ARI who were tested with a multiplex PCR assay. Retrospective chart review was done on these patients admitted from January 2018 to February 2020. @*Results@#There were 47 charts reviewed, mean age was 4.2 years old. Out of 47 patients, 36 (76.6%) tested positive for a pathogen. Respiratory syncytial virus (RSV) being the most common followed by Influenza A/H1-2009 and Human metapneumovirus (hMPV). Two patients had viral co-infections and no bacteria were detected on all subjects. 61.7% patients were started on antibiotics on admission. Fever and cough were the most common sign and symptom, respectively. Normal WBC (68% with neutrophilic predominance) and platelet were detected in 72.3% and 70.2% of patients, respectively; 50% of patients had normal CRP and 60.5% had abnormal findings on chest x-ray. Only the presence of chest x-ray findings was found to have a higher probability of yielding a positive Respiratory Panel p=0.27. @*Conclusion@#Among admitted patients with ARI, 76.6% tested positive for a respiratory pathogen. All were caused by viruses presenting as nonspecific manifestations – fever and cough. Clinical manifestations, CBC and CRP showed no association with the Respiratory Panel result while abnormal chest x-ray had a higher probability of yielding a positive Respiratory Panel result.

Clinical profile and outcome of admitted pediatric patients with Influenza

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.

Impact of an international nosocomial infection control consortium multidimensional approach on catheter-associated urinary tract infections in adult intensive care units in the Philippines: international nosocomial infection control consortium [INICC] findings

To assess the impact of a multidimensional infection control approach on the reduction of catheter-associated urinary tract infection [CAUTI] rates in adult intensive care units [AICUs] in two hospitals in the Philippines that are members of the International Nosocomial Infection Control Consortium. This was a before-after prospective active surveillance study to determine the rates of CAUTI in 3183 patients hospitalized in 4 ICUS over 14,426 bed-days. The study was divided into baseline and intervention periods. During baseline, surveillance was performed using the definitions of the US Centers for Disease Control and Prevention and the National Healthcare Safety Network [CDC/NHSN]. During intervention, we implemented a multidimensional approach that included: [1] a bundle of infection control interventions, [2] education, [3] surveillance of CAUTI rates, [4] feedback on CAUTI rates, [5] process surveillance and [6] performance feedback. We used random effects Poisson regression to account for the clustering of CAUTI rates across time. We recorded 8720 urinary catheter [UC]-days: 819 at baseline and 7901 during intervention. The rate of CAUTI was 11.0 per 1000 UC-days at baseline and was decreased by 76% to 2.66 per 1000 UC-days during intervention [rate ratio [RR], 0.24; 95% confidence interval [CI], 0.11-0.53; P-value, 0.0001]. Our multidimensional approach was associated with a significant reduction in the CAUTI rates in the ICU setting of a limited-resource country