In Analysis of multidrug-resistant bacteria in 3223 patients with hospital-acquired infections (HAI) from a tertiary general hospital in China , Wang et. al (2019) claim that due to the misuse and abuse of antibiotics in medical and agricultural settings, there has been a global uptake in antimicrobial resistance. Also, they observe that multi-drug resistant (MDR) bacteria are now acknowledged as a prominent cause of hospital-acquired infections (HAI). Wang et al (2019) assert that it is fundamental to understand the medical characteristics, occurrence, and spread of MDR bacteria-based nosocomial infections for effective treatment. To prove their argument, they chose to investigate the frequency, dispersal, and antimicrobial weakness rates of MDR bacteria in patients with HAI from a tertiary Chinese hospital.
The above-mentioned article draws insight from prior research findings tackling antimicrobial resistance. For instance, it draws upon the proposed definitions of multidrug-resistant, extensively drug-resistant and pan drug-resistant bacteria as acknowledged in the work of Magiorakos et. al (2012). Also, it incorporates the insights of Antony and Parija (2016) along with Arenz and Wilson (2016) to lend credence to their claim of the clinical and economic impacts of MDR bacteria-based nosocomial infections (Wang et. al, 2019). To put it succinctly, this article builds on previous research findings.
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To investigate the frequency, dispersal, and antimicrobial weakness rates of MDR bacteria in patients, Wang et. al (2019) conducted a 3-year retrospective evaluation of patients with a confirmed diagnosis of a bacterial infection at a tertiary hospital in Jining, China. Age, sex, samples, treatment, microbiology results, and antibiotic resistance patterns of isolates are the demographic and clinical dimensions of the data generated during the evaluation (Wang et. al, 2019). This data was extracted from the hospitals’ Laboratory Information System (LIS). The researchers applied the National Health and Family Planning Commission of the People’s Republic of China’s (NHFPC) Hospital Infection Diagnosis Standard in determining HAI cases. Technical guidelines for the prevention and control of MDR bacteria-based nosocomial infections of the Chinese republic informed the collection of specimen from numerous sources (Wang et. al, 2019). They manipulated atmospheric conditions for the cultured samples and used the VITEK 2 COMPACT system and quality control strains in bacterial identification. Similarly, for antimicrobial susceptibility testing, they observed atmospheric manipulation and conducted the testing using the above-mentioned system and standardized inoculum. The conduct of this exercise was consistent with the 24 th edition of the Clinical and Laboratory Standards Institute (CLSI) standards (Wang et. al, 2019). They defined MDR bacteria as those strains that displayed resistance to at least 3 antibiotic classes. The site for the above-mentioned study was a tertiary Chinese hospital with a bed capacity of approximately 4,200 and the researchers screened approximately 15,600 patients over a 3-year period.
According to Wang et.al (2019), close to 7,600 patients in the study sample tested positive for nosocomial infections. Male patients were comparatively overrepresented while 55 years was the median age. The departments of neurology; neurosurgery, orthopedics, and joint surgery, urology, plastic surgery, oncology, respiratory unit, gastroenterology, nephrology, and intensive care unit (ICU) provided the majority of the patients with HAIs (Wang et. al, 2019). Furthermore, nearly 4 in 10 isolate samples tested indicated the presence of MDR with ESBLECO, MDRPA and MDRAB the most popular strains. Likewise, male and elderly patients are overrepresented in MDR-based infections. Wang et. al (2019) obtained MDR positive isolates from sources like sputum, secretions, blood, urine, and pus, of which the former most source provided almost 70% of these isolates. Comprehensive ICU; neurosurgery ICU; neonatal ICU and the neurology department provided the majority of patients with MDR bacterial infections. The ESBLECO bacteria was present in patients from all departments and was overrepresented in the neurosurgery and neonatal ICUs respectively (Wang et. al, 2019). Similarly, antibiotic susceptibility of MDR strains reveal that MRSA isolates as being resistant to at least 5 antimicrobial agents and sensitive to 4; ESBLECO isolates resistant to at least 3 agents and responsive to 4; ESBLKPN isolates sensitive to 4 and resistant to a similar amount of antimicrobial agents (Wang et. al, 2019). Generally, the findings highlighted the sensitivity and resistance of numerous MDR strains.
Wang et. al (2018) assert that: ‘Understanding the clinical characteristics, prevalence, and distribution of nosocomial infections caused by MDR bacteria is crucial for effective treatment’. Therefore, the problem was the evaluation of the medical traits, occurrence, and spread of MDR-based HAIs. This is consistent with the narrative of improving patient safety. Their methodology selection is appropriate for solving the stated problem for the outcomes are sensitive to the parameters of the research problem. The findings are reported clearly and consistently, however, the researchers fail to acknowledge and explain any limitations (Wang et. al, 2019). Despite that, the logic is clear and well supported by the data. Frankly, am persuaded by the thesis and consider the findings credible. In estimating how the article contributes to the knowledge, the author of this paper refers to the sensitivity and resistance of different MDR strains. It highlights the efficacy of current antimicrobial agents. That knowledge can be applied to strengthen MDR bacteria surveillance as well as prevent the excessive use of antibiotics at least in medical settings. Implicitly, therefore this knowledge has applications in enhancing patient safety by reducing cases of HAIs.
Reference
Wang, M., Wei, H., Zhao, Y., Shang, L., Di, L., Lyu, C. & Liu, J. (2019). Analysis of multidrug-resistant bacteria in 3223 patients with hospital-acquired infections (HAI) from a tertiary general hospital in China. Bosnian Journal of Basic Medical Sciences , 19(1): pp. 86-93.
