Epidemiology and Antimicrobial Resistance Profiles of Bacterial Isolates from Clinical Specimens at Felege Hiwot Comprehensive Specialized Hospital in Ethiopia: Retrospective Study

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This manuscript describes the isolation of bacterial pathogens from clinical specimens in a Ethiopian hospital for 3 years. This may provides potentially important information. However, presentations in text and Tables/Figures are occasionally not suitable and lacks uniformity among Tables. Although this manuscript is not suitable for international journal, authors are recommended to rearrange the contents.

1. Title is very strange. This must be changed.

2. line 26: "isolates were isolated" should be rephrased.

3. Table 1. meaning of "unknown" is not clear. What is unknown? 

4. Table 2, 3: There is a line of "Missing (blank)". There is no explanation in this table.

5. Figure 2,3,4,5: There is a head above figure in addition to figure legend below. The head should be deleted, and included in figure legend.

6. Table 8.  For S. aureus, possible PDR is shown as 7 (2%). However, S. aureus is all susceptible to vancomycin. Why are there such PDR isolates?

7. Table 6 shows MRSA rate as 30% (120/356). However, in Table 10, S. aureus - FOX shows 37.2% resistance among 356 isolates. FOX-resistant S. aureus is called MRSA. However, presented results were different. 

8.  Table 5 should be deleted. 

9. Discussion appears to be poor. The unique points in this study should be described, with their possible reasons.     

Comments on the Quality of English Language

There are many poor wording and expressions.

Author Response

Dear Reviewer 1,

We are pleased to have the opportunity to revise our manuscript entitled “(Manuscript ID: bacteria-3156491 Distribution and Antimicrobial Resistance Profiles from Culture-Positive Clinical Specimens at Felege Hiwot Comprehensive Specialized Hospital in Ethiopia: Retrospective Study)”. 

We wish to express our gratitude to your thorough evaluation of the manuscript. In the revised version, we have made every effort to address the comments raised by you in a detailed, point-by-point manner. We submitted the corrected manuscript in its track change and the clear version

Reviewers' comments and responses:

Reviewer 1: This manuscript describes the isolation of bacterial pathogens from clinical specimens in a Ethiopian hospital for 3 years. This may provides potentially important information. However, presentations in text and Tables/Figures are occasionally not suitable and lacks uniformity among Tables. Although this manuscript is not suitable for international journal, authors are recommended to rearrange the contents.

#1. Title is very strange. This must be changed.

Thank you for your valuable comments dear reviewer. Corrected as suggested

#2. line 26: "isolates were isolated" should be rephrased.

Thank you dear reviewer, corrected as suggested

#3. Table 1. meaning of "unknown" is not clear. What is unknown? 

Thank you dear reviewer, corrected as suggested. It has been clarified at the footnote of the table.

#4. Table 2, 3: There is a line of "Missing (blank)". There is no explanation in this table.

Thank you dear reviewer, it has been clarified on the Table 2’s and Table 3‘s footnote

#5. Figure 2,3,4,5: There is a head above figure in addition to figure legend below. The head should be deleted, and included in figure legend.

Thank you dear reviewer, corrected as suggested

#6. Table 8.  For S. aureus, possible PDR is shown as 7 (2%). However, S. aureus is all susceptible to vancomycin. Why are there such PDR isolates?

Dear reviewer would like to thank very match basically in this regard. Because it was great discrepancy that was happen during data clearing. We corrected it accordingly.

#7. Table 6 shows MRSA rate as 30% (120/356). However, in Table 10, S. aureus - FOX shows 37.2% resistance among 356 isolates. FOX-resistant S. aureus is called MRSA. However, presented results were different.

Thank you once again dear reviewer it was clerical error. Just we corrected it

#8.  Table 5 should be deleted. 

Thank you dear reviewer, corrected as suggested

#9. Discussion appears to be poor. The unique points in this study should be described, with their possible reasons.     

Thank you once again dear reviewer, just we tried to add some important points with their possible reasons. Basically as this study is retrospective just we can’t go beyond this. We fail to incorporate variables.

These  were our points for discussion

1. Specimen distribution

• Size
• Isolate proportion

2. Isolate epidemiology

• Wards
• Variables like age and sex

3. Common Pathogens Identified

• Prevalence of Pathogens

4. Pathogen-Specific Resistance:

• Implications for Treatment Guidelines
• Inappropriate Empirical Therapy
• Need for Updated Guidelines

5. Infection Prevention and Control (IPC)

• Role of IPC Practices:
• Impact of Hospital Resources and Capacity

6. Antimicrobial Resistance (AMR) 

• Comparison to Global and National 
• Emergence of Multi-Drug Resistance (MDR)

7. Limitations of the Study

• Study Design Limitations:
• Limitations in Data Collection:

8. AMR as a Public Health Threat:

 

Reviewer 2 Report

Comments and Suggestions for Authors

The current study focused on culture-positive clinical specimens from the FHCSH Microbiology Laboratory. According to the analysis, the sample volume was relatively good. There are really too many figures and too many tables; they should be partly eliminated and grouped together.

Author Response

 

Dear Reviewer 2,

We are pleased to have the opportunity to revise our manuscript entitled “(Manuscript ID: bacteria-3156491 Distribution and Antimicrobial Resistance Profiles from Culture-Positive Clinical Specimens at Felege Hiwot Comprehensive Specialized Hospital in Ethiopia: Retrospective Study)”.  

We would like to express our gratitude to you for their thorough evaluation of the manuscript. In the revised version, we have made every effort to address the comments raised by you in a detailed, point-by-point manner. We submitted the corrected manuscript in its track change and the clear version. 

#1There are many poor wording and expressions.

Thank you dear reviewer, we assessed, revised and edited most of the statements to enhance the fluency.

#2. The current study focused on culture-positive clinical specimens from the FHCSH Microbiology Laboratory. According to the analysis, the sample volume was relatively good. There are really too many figures and too many tables; they should be partly eliminated and grouped together

Thank you once again for your suggestions dear reviewer 2. We tried to minimize as much as possible. For example we omitted Table 5. This was happened due to the broadness of the study scope. The analysis was done for all biological samples, from all age, for all isolates, in all wards and resistance profile for most common antibiotics.

Kind regards,

Mulat Erkihun, Corresponding author 

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

1. Authors corrected title. However, still it is strange. It should be "...Bacterial isolates from clinical specimens.....". "Culture-positive" must be deleted.

2. Color drawing (yellow, red) on all Tables must be deleted. Tables should not be drawn in color. 

Comments on the Quality of English Language

Generally OK.

Author Response

Dear reviewer,

We are pleased to have the opportunity to revise our manuscript entitled “(Manuscript ID: bacteria-3156491 Epidemiology and Antimicrobial Resistance Profiles of Bacterial isolates from Culture-Positive Clinical Specimens at Felege Hiwot Comprehensive Specialized Hospital in Ethiopia: Retrospective Study)”.  

Once again we need to extend our sincere appreciation to you for your insightful  suggestions, which greatly enhances the quality of our paper.  In the revised version, we have made  a change to the minor comments raised. We submitted the corrected manuscript in its track change and the clear version including point-by-point explanations.

Reviewer's comments and responses:

Reviewer 1:

#1. Authors corrected title. However, still it is strange. It should be "...Bacterial isolates from clinical specimens.....". "Culture-positive" must be deleted.

Thank you for your valuable comments dear reviewer. Corrected as suggested

#2. Color drawing (yellow, red) on all Tables must be deleted. Tables should not be drawn in color.

Thank you dear reviewer, corrected as suggested

Kind regards,  

Mulat Erkihun, Corresponding author