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Article ; Online: Prevention and treatment of tuberculosis in solid organ transplant recipients.

Abad, Cybele L / Razonable, Raymund R

2019 Volume 18, Issue 1, Page(s) 63–73

Abstract: ... ...

Abstract	Introduction
MeSH term(s)	Antitubercular Agents/administration & dosage ; Antitubercular Agents/adverse effects ; Drug Interactions ; Humans ; Immunosuppressive Agents/administration & dosage ; Immunosuppressive Agents/adverse effects ; Latent Tuberculosis/drug therapy ; Organ Transplantation ; Tuberculosis/drug therapy ; Tuberculosis/prevention & control ; Tuberculosis, Multidrug-Resistant/drug therapy
Chemical Substances	Antitubercular Agents ; Immunosuppressive Agents
Language	English
Publishing date	2019-12-18
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2181279-2
ISSN	1744-8336 ; 1478-7210
ISSN (online)	1744-8336
ISSN	1478-7210
DOI	10.1080/14787210.2020.1704255
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Zs.A 6106: Show issues

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Article ; Online: Assessment of knowledge and implementation practices of the ventilator acquired pneumonia (VAP) bundle in the intensive care unit of a private hospital.

Abad, Cybele Lara / Formalejo, Cordella P / Mantaring, Dan Meynard L

Antimicrobial resistance and infection control

2021 Volume 10, Issue 1, Page(s) 161

Abstract: Studies have shown that a ventilator associated pneumonia (VAP) bundle significantly decreases VAP rates. In this study, we evaluated existing knowledge, practices, and adherence of nurses and infection control preventionists (ICP) to the VAP bundles of ... ...

Abstract	Studies have shown that a ventilator associated pneumonia (VAP) bundle significantly decreases VAP rates. In this study, we evaluated existing knowledge, practices, and adherence of nurses and infection control preventionists (ICP) to the VAP bundles of care in the intensive care unit (ICU) by using qualitative and quantitative tools. Of 60 participants (56 nurses and 4 ICPs), mean knowledge score regarding specific evidence-based VAP guidelines was 5 (range 3-8) out of 10 points. Self-reported adherence to the VAP bundle ranged from 38.5 to 100%, with perfect compliance to head of bed elevation, and poorest compliance with readiness to extubate. Overall VAP median bundle compliance was 84.6%. Knowledge regarding specific components of VAP prevention is lacking. Formal training and interactive educational sessions should be performed regularly to assess the competency of key personnel regarding the VAP bundle, especially in the context of rapid nurse turnover. Incentives for retention of nurses should also be considered, so that knowledge of hospital specific initiatives such as the VAP bundles of care can be cultivated over time.
MeSH term(s)	Adult ; Female ; Health Knowledge, Attitudes, Practice ; Health Personnel/psychology ; Health Personnel/statistics & numerical data ; Health Plan Implementation/methods ; Health Plan Implementation/standards ; Hospitals, Private/statistics & numerical data ; Humans ; Infection Control/standards ; Intensive Care Units ; Male ; Middle Aged ; Nurses/psychology ; Nurses/statistics & numerical data ; Pneumonia, Ventilator-Associated/prevention & control ; Pneumonia, Ventilator-Associated/psychology ; Ventilators, Mechanical/adverse effects
Language	English
Publishing date	2021-11-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2666706-X
ISSN	2047-2994 ; 2047-2994
ISSN (online)	2047-2994
ISSN	2047-2994
DOI	10.1186/s13756-021-01027-1
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Article ; Online: A retrospective review of infections and outcomes within 100 days of hematopoietic stem cell transplantation: insights from a new transplant program in the Philippines.

Bello, Jia An G / Cruz, Angela Beatriz / Virata, Ma Patricia / Calavera, Alma / Abad, Cybele L

IJID Regions (Online)

2022 Volume 3, Page(s) 101–105

Abstract: Background: Few hematopoietic stem cell transplantations (HSCT) are performed in lower-middle income countries. Only four institutions in the Philippines are able to perform transplants. This study describes the experience of a newly established program. ...

Abstract	Background: Few hematopoietic stem cell transplantations (HSCT) are performed in lower-middle income countries. Only four institutions in the Philippines are able to perform transplants. This study describes the experience of a newly established program. Methods: The charts of all adult patients who underwent HSCT at The Medical City from May 1, 2016 to December 31, 2019 were reviewed retrospectively. Results: A total of 33 patients were included in the cohort, of whom 31 (93.9%) underwent autologous HSCT and only two (6.1%) underwent allogeneic HSCT. Most were female (21/33, 63%), and median age was 51 years (range 21-67 years). The primary indication for transplantation was multiple myeloma ( Conclusions: This cohort with mostly autologous HSCT had favorable outcomes in the first 100 days. Rates of bacterial infection were high in the early post-transplant period. Latent TB infection was common, but no reactivation was observed. Longer-term follow-up of patients is needed to determine late post-transplant complications and outcomes.
Language	English
Publishing date	2022-03-20
Publishing country	England
Document type	Journal Article
ISSN	2772-7076
ISSN (online)	2772-7076
DOI	10.1016/j.ijregi.2022.03.011
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Article ; Online: The clinical profile and outcomes of adult patients given intravenous colistin for multidrug-resistant gram negative infections in a Philippine tertiary hospital.

Li, Kingbherly L / Abad, Cybele Lara R

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

2020 Volume 93, Page(s) 9–14

Abstract: Objectives: Colistimethate sodium (colistin) is used to treat multidrug-resistant gram negative infections. We describe the profile and outcomes of patients given colistin in a tertiary level government hospital in Manila, Philippines.: Methods: We ... ...

Abstract	Objectives: Colistimethate sodium (colistin) is used to treat multidrug-resistant gram negative infections. We describe the profile and outcomes of patients given colistin in a tertiary level government hospital in Manila, Philippines. Methods: We performed a retrospective study of adult patients given intravenous colistin between January 2015 to June 2018 in the Philippine General Hospital. We defined clinical success as a composite of hemodynamic stability, quick Sequential Organ Failure Assessment (qSOFA) score, and microbiological cure. Results: 250 patients were included, half (49.2%) were admitted in the ICU. Median age was 55 years. There was an increase in qSOFA, APACHE II score, and septic shock from baseline to 24 h prior to colistin use. Most patients had pneumonia (90.8%) with extensively drug-resistant Acinetobacter baumannii as the most common isolate (78.8%). Colistin was given in combination with meropenem (96.4%) for a median of 12 days. Nephrotoxicity was seen in 30.8%, with renal replacement therapy needed in 6%. Clinical success was seen in 61.2% of patients and overall mortality was 41.6%. Conclusion: Colistin was frequently used in combination with a carbapenem for treatment of XDR-related respiratory infections. Nephrotoxicity was a common adverse effect. Clinical success was modest and overall mortality was high.
MeSH term(s)	Acinetobacter Infections/drug therapy ; Acinetobacter Infections/microbiology ; Acinetobacter baumannii/isolation & purification ; Administration, Intravenous ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/administration & dosage ; Anti-Bacterial Agents/adverse effects ; Anti-Bacterial Agents/therapeutic use ; Carbapenems/therapeutic use ; Colistin/administration & dosage ; Colistin/adverse effects ; Colistin/analogs & derivatives ; Colistin/therapeutic use ; Drug Resistance, Multiple, Bacterial ; Drug Therapy, Combination ; Female ; Gram-Negative Bacterial Infections/diagnosis ; Gram-Negative Bacterial Infections/drug therapy ; Gram-Negative Bacterial Infections/microbiology ; Gram-Negative Bacterial Infections/mortality ; Hospitalization ; Humans ; Male ; Meropenem/therapeutic use ; Middle Aged ; Organ Dysfunction Scores ; Philippines ; Respiratory Tract Infections/drug therapy ; Retrospective Studies ; Tertiary Care Centers ; Treatment Outcome ; Young Adult
Chemical Substances	Anti-Bacterial Agents ; Carbapenems ; colistinmethanesulfonic acid (DL2R53P963) ; Meropenem (FV9J3JU8B1) ; Colistin (Z67X93HJG1)
Language	English
Publishing date	2020-01-21
Publishing country	Canada
Document type	Journal Article
ZDB-ID	1331197-9
ISSN	1878-3511 ; 1201-9712
ISSN (online)	1878-3511
ISSN	1201-9712
DOI	10.1016/j.ijid.2020.01.022
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Zs.A 4516: Show issues

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Article ; Online: A systematic review of the effectiveness of cohorting to reduce transmission of healthcare-associated

Abad, Cybele L / Barker, Anna K / Safdar, Nasia

Infection control and hospital epidemiology

2020 Volume 41, Issue 6, Page(s) 691–709

Abstract: Background: Cohorting of patients and staff is a control strategy often used to prevent the spread of infection in healthcare institutions. However, a comprehensive evaluation of cohorting as a prevention approach is lacking.: Methods: We performed a ...

Abstract	Background: Cohorting of patients and staff is a control strategy often used to prevent the spread of infection in healthcare institutions. However, a comprehensive evaluation of cohorting as a prevention approach is lacking. Methods: We performed a systematic review of studies that used cohorting as part of an infection control strategy to reduce hospital-acquired infections. We included studies published between 1966 and November 30, 2019, on adult populations hospitalized in acute-care hospitals. Results: In total, 87 studies met inclusion criteria. Study types were quasi-experimental "before and after" (n = 35), retrospective (n = 49), and prospective (n = 3). Case-control analysis was performed in 7 studies. Cohorting was performed with other infection control strategies in the setting of methicillin-resistant Staphylococcus aureus (MRSA, n = 22), Clostridioides difficile infection (CDI, n = 6), vancomycin-resistant Enterococcus (VRE, n = 17), carbapenem-resistant Enterobacteriaceae infections (CRE, n = 22), A. baumannii (n = 15), and other gram-negative infections (n = 5). Cohorting was performed either simultaneously (56 of 87, 64.4%) or in phases (31 of 87, 35.6%) to help contain transmission. In 60 studies, both patients and staff were cohorted. Most studies (77 of 87, 88.5%) showed a decline in infection or colonization rates after a multifaceted approach that included cohorting as part of the intervention bundle. Hand hygiene compliance improved in approximately half of the studies (8 of 15) during the respective intervention. Conclusion: Cohorting of staff, patients, or both is a frequently used and reasonable component of an enhanced infection control strategy. However, determining the effectiveness of cohorting as a strategy to reduce transmission of MDRO and C. difficile infections is difficult, particularly in endemic situations.
MeSH term(s)	Clostridioides difficile ; Clostridium Infections/prevention & control ; Cross Infection/prevention & control ; Delivery of Health Care ; Drug Resistance, Multiple, Bacterial ; Enterococcus ; Gram-Negative Bacterial Infections/prevention & control ; Humans ; Infection Control/methods ; Methicillin-Resistant Staphylococcus aureus ; Prospective Studies ; Retrospective Studies ; Staphylococcal Infections/prevention & control
Language	English
Publishing date	2020-03-24
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Systematic Review
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2020.45
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Zs.A 1714: Show issues

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Article ; Online: Evaluating carbapenem restriction practices at a private hospital in Manila, Philippines as a strategy for antimicrobial stewardship

Kaitlin F. Mitchell / Nasia Safdar / Cybele L. Abad

Archives of Public Health, Vol 77, Iss 1, Pp 1-

2019 Volume 6

Abstract: Abstract Background Hospital antimicrobial stewardship programs are especially critical in countries such as the Philippines, where antibiotic resistant infections are highly prevalent. At the study institution in Manila, Philippines, a Prior Approval ... ...

Abstract	Abstract Background Hospital antimicrobial stewardship programs are especially critical in countries such as the Philippines, where antibiotic resistant infections are highly prevalent. At the study institution in Manila, Philippines, a Prior Approval for Restricted Antimicrobials (PARA) is required for non-infectious disease specialists to prescribe certain antimicrobials, including carbapenems. PARA request forms include specification of empiric or definitive therapy based on diagnostic tests. Recommended duration of therapy is typically 3 days for empiric use and 7 days for definitive, with possible extension upon specialist approval. Methods The study took place at an 800-bed tertiary hospital. We performed a retrospective review of patient medical records and laboratory reports dating from January 1 to December 31, 2016. Information related to patient demographics, carbapenem prescription, laboratory diagnosis, and therapy were compiled. Carbapenem prescriptions were classified as ‘adherent’ or ‘non-adherent’ according to clinical guidelines related to infection diagnosis, treatment duration, and de-escalation. Results Of the 185 patients on carbapenem therapy, Prescriptions of carbapenems were either definitive (n = 56), empiric (n = 127), or prophylactic (n = 2) as defined by the ordering provider. 69 out of 185 (37%) prescriptions were deemed non-adherent to guidelines, despite receiving approvals for their respective requests. Of these, 72% were non-adherent due to failure to de-escalate the carbapenem and 28% were non-adherent due to an incomplete course of therapy. Conclusion Despite initial PARA approval for carbapenem therapy, 37% of prescriptions were non-guideline-adherent, highlighting the ongoing challenges in implementing this type of stewardship strategy. In order to increase the effectiveness of PARA, additional approaches may be warranted, including the application of strict policies which reinforce follow-up of available culture results, justification of therapy extension, or referral to an ...
Keywords	Antimicrobial stewardship ; Philippines ; Carbapenem ; Empiric and definitive prescriptions ; Public aspects of medicine ; RA1-1270
Subject code	610
Language	English
Publishing date	2019-07-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The effectiveness of a dedicated central venous access care team to prevent catheter-related bloodstream infection in a private hospital.

Abad, Cybele L / Bello, Jia An G / Maño, Maria Jesusa / de Lara, Fortune Charles V / Perez, Ma Cristina P

Infection prevention in practice

2022 Volume 5, Issue 1, Page(s) 100259

Abstract: Objective: We hypothesized a dedicated team would decrease catheter-related bloodstream infection (CRBSI) rates.: Method: We implemented a before-after study.: Results: CRBSI frequency (39/103 vs. 28/105, P=0.084) and incidence (36.61/1000 vs. 26 ... ...

Abstract	Objective: We hypothesized a dedicated team would decrease catheter-related bloodstream infection (CRBSI) rates. Method: We implemented a before-after study. Results: CRBSI frequency (39/103 vs. 28/105, P=0.084) and incidence (36.61/1000 vs. 26.1/1000 catheter-days, Conclusion: The intervention delayed median time to CRBSI, but was insufficient to decrease overall rates.
Language	English
Publishing date	2022-11-23
Publishing country	England
Document type	Journal Article
ISSN	2590-0889
ISSN (online)	2590-0889
DOI	10.1016/j.infpip.2022.100259
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Article: Evaluating carbapenem restriction practices at a private hospital in Manila, Philippines as a strategy for antimicrobial stewardship.

Mitchell, Kaitlin F / Safdar, Nasia / Abad, Cybele L

Archives of public health = Archives belges de sante publique

2019 Volume 77, Page(s) 31

Abstract: Background: Hospital antimicrobial stewardship programs are especially critical in countries such as the Philippines, where antibiotic resistant infections are highly prevalent. At the study institution in Manila, Philippines, a Prior Approval for ... ...

Abstract	Background: Hospital antimicrobial stewardship programs are especially critical in countries such as the Philippines, where antibiotic resistant infections are highly prevalent. At the study institution in Manila, Philippines, a Prior Approval for Restricted Antimicrobials (PARA) is required for non-infectious disease specialists to prescribe certain antimicrobials, including carbapenems. PARA request forms include specification of empiric or definitive therapy based on diagnostic tests. Recommended duration of therapy is typically 3 days for empiric use and 7 days for definitive, with possible extension upon specialist approval. Methods: The study took place at an 800-bed tertiary hospital. We performed a retrospective review of patient medical records and laboratory reports dating from January 1 to December 31, 2016. Information related to patient demographics, carbapenem prescription, laboratory diagnosis, and therapy were compiled. Carbapenem prescriptions were classified as 'adherent' or 'non-adherent' according to clinical guidelines related to infection diagnosis, treatment duration, and de-escalation. Results: Of the 185 patients on carbapenem therapy, Prescriptions of carbapenems were either definitive ( Conclusion: Despite initial PARA approval for carbapenem therapy, 37% of prescriptions were non-guideline-adherent, highlighting the ongoing challenges in implementing this type of stewardship strategy. In order to increase the effectiveness of PARA, additional approaches may be warranted, including the application of strict policies which reinforce follow-up of available culture results, justification of therapy extension, or referral to an infectious disease specialist.
Language	English
Publishing date	2019-07-04
Publishing country	England
Document type	Journal Article
ZDB-ID	1117688-x
ISSN	2049-3258 ; 0778-7367 ; 0003-9578
ISSN (online)	2049-3258
ISSN	0778-7367 ; 0003-9578
DOI	10.1186/s13690-019-0358-9
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Article ; Online: Bacterial coinfection and antimicrobial use among patients with COVID-19 infection in a referral center in the Philippines: A retrospective cohort study.

Abad, Cybele L / Sandejas, Joanne Carmela M / Poblete, Jonnel B / Malundo, Anna Flor G / Salamat, Maria Sonia S / Alejandria, Marissa M

IJID Regions (Online)

2022 Volume 4, Page(s) 123–130

Abstract: Objective: This study aimed to describe community-acquired bacterial coinfection (CAI) and antimicrobial use among COVID-19 patients.: Methods: Electronic records were retrospectively reviewed, and clinical data, laboratory data, antibiotic use, and ... ...

Abstract	Objective: This study aimed to describe community-acquired bacterial coinfection (CAI) and antimicrobial use among COVID-19 patients. Methods: Electronic records were retrospectively reviewed, and clinical data, laboratory data, antibiotic use, and outcomes of patients with and without CAI were compared. Results: Of 1116 patients, 55.1% received antibiotics within 48 hours, but only 66 (5.9%) had documented CAI, mainly respiratory (40/66, 60.6%). Patients with CAI were more likely to present with myalgia ( Conclusion: Overall CAI rate was low (5.9%) and antimicrobial use disproportionately high (55.0%), varying little over time. The mortality rate of coinfected patients was high. Certain parameters can be used to better identify those with CAI and those who need blood cultures.
Language	English
Publishing date	2022-07-08
Publishing country	England
Document type	Journal Article
ISSN	2772-7076
ISSN (online)	2772-7076
DOI	10.1016/j.ijregi.2022.07.003
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Article ; Online: Non-tuberculous mycobacterial infections in solid organ transplant recipients: An update.

Abad, Cybele L / Razonable, Raymund R

Journal of clinical tuberculosis and other mycobacterial diseases

2016 Volume 4, Page(s) 1–8

Abstract: Non-tuberculous mycobacteria are ubiquitous environmental organisms that are now increasingly recognized as important causes of clinical disease in solid organ transplant recipients. Risk factors of non-tuberculous mycobacteria infection are severe ... ...

Abstract	Non-tuberculous mycobacteria are ubiquitous environmental organisms that are now increasingly recognized as important causes of clinical disease in solid organ transplant recipients. Risk factors of non-tuberculous mycobacteria infection are severe immunologic defects and structural abnormalities. Lung transplant recipients are at higher risk for non-tuberculous mycobacterial disease compared to recipients of other solid organs. The clinical presentation could be skin and soft tissue infection, osteoarticular disease, pleuropulmonary infection, bloodstream (including catheter-associated) infection, lymphadenitis, and disseminated or multi-organ disease. Management of non-tuberculous mycobacteria infection is complex due to the prolonged treatment course with multi-drug regimens that are anticipated to interact with immunosuppressive medications. This review article provides an update on infections due to non-tuberculous mycobacteria after solid organ transplantation, and discusses the epidemiology, risk factors, clinical presentation, and management.
Language	English
Publishing date	2016-04-27
Publishing country	England
Document type	Journal Article ; Review
ISSN	2405-5794
ISSN (online)	2405-5794
DOI	10.1016/j.jctube.2016.04.001
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