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.

Profile of pediatric patients with dengue fever/dengue hemorrhagic fever over a five-year period (2000-2004)

Objectives: This study was conducted to determine the clinico-demographic profile of pediatric patients who were admitted for dengue infection at the Research Institute for Tropical Medicine (RITM) from 2000 to 2004. Methods: This is a retrospective, descriptive study. Charts of patients who were less than 19 years of age and were admitted at the RITM due to confirmed dengue (using paired dengue HI titer results) were reviewed. Conclusion: The clinico-demographic profile of patients involved in the study was very similar to that of other studies done, both locally and abroad. By using Spearman's correlation of ranks, the study showed that there was no significant relationship between the severity of dengue infection based on the World Health Organization (WHO) Grade and whether it was a primary or secondary infection with r=.018, p-value=.025.