LIMITED FACE-TO-FACE MODULE
Enriched Virtual Mode: Pre-Deployment
JOURNAL CRITIQUE
Hospital Assignment:
Name:
Journal Article Title: Escherichia coli Isolated from Urinary Tract Infections of Lebanese Patients between
2000 and 2009: Epidemiology and Profiles of Resistance
Elements influencing the believability of the
research
Writing Style
● Is the report well written – concise,
grammatically correct, avoid the
use of jargon? It is well laid out
and organized?
Author
● Do the researcher(s’) qualifications
or positions indicate a degree of
knowledge in this particular field?
Date Submitted:
Class number:
YES NO Comments and Evidences
V1
The writing style used in the report was straightforward,
concise, and organized. Despite having some jargon,
the paper was relatively easy to understand because
the authors didn’t overcomplicate the wording. The flow
of paper was also simple and organized, which made it
easier to follow through on. As for grammatical issues,
nothing that would affect the outcome of the results was
detected.
✅ V2
The report journal was able to provide the readers with
well-written, concise and grammatically correct
information. It was presented in a logical manner
wherein the sentences were coherent to one another
which significantly helps the readers to follow the flow of
the topic. Although the authors used medical jargon, the
usage of these words were put to a context where the
general population can comprehend the data. This
cannot be an issue because the topic requires the use
of these words given its nature. Overall, the paper was
well laid out and organized.
V1 (paraphrase pls)
The researchers are both from the Faculty of
Medicine in the University of Balamand in
Lebanon. This makes them qualified enough
to have knowledge on the topic. Additionally,
the first page includes their profile in which it
can be seen that they have multiple published
articles and thousands of citations making
them more credible bearers of knowledge in
 the topic.

The title properly represents the research,

specifically its objectives and the methods.
The title shows that the research design is a
retrospective study whose sample involved
UTI-infected Lebanese patients from a 10-year
period (2000 to 2009). Their goal was to
isolate E. coli from these patients and study its
epidemiology and antibiotic resistance. [pa-
paraphrase nalang eto kasi sagot ko :>]
l/

Report Title V2
● Is the title clear, accurate, and The title “Escherichia coli Isolated from Urinary
unambiguous? Tract Infections of Lebanese Patients between
2000 and 2009: Epidemiology and Profiles of
Resistance” is clear and concise. It serves as
a bird’s eye view on the main theme of the
paper. It directly implies to the readers that the
paper is about antimicrobial resistance of
Escherichia coli. The words used were
accurate and appropriate which makes the title
easy to understand for all types of readers.
The title is not wordy, and it has an optimal
length.

Abstract ✓ The abstract offers a clear overview of

the study. The study's purpose was to
● Does the abstract offer a clear
investigate the bacterial etiology of
overview of the study including the
urinary tract infections in one of the
research problem, sample,
methodology, finding, and busiest hospitals in Lebanon and to
recommendations? examine epidemiologic and
microbiologic properties of Escherichia
coli isolated from urinary tract infections of
Lebanese patients over ten years. The
methods discussed how data was analyzed
and generated between 2000 and 2009. How
bacterial identification was based on
standard culture and biochemical
characteristics of isolates, antimicrobial
susceptibility testing through disk diffusion

Elements influencing the robustness of the
YES
research
Purpose/Research Problem
● Is the purpose of the study or
research problem clearly stated?
Logical Consistency
● Does the research report follow ✓
the steps of the research process
in a logical manner?
Literature Review
method, and the detection ESBL production.
Furthermore, the results were presented
wherein E. coli was the most frequent
isolate throughout the ten years, E. coli
which occurred more frequently in women
than in men was followed by other organisms
Klebsiella pneumoniae and Proteus sp.,
Pseudomonas aeruginosa, Enterococcus
sp., and Streptococcus agalactiae. The
results also stated that piperacillin and
ampicillin were the least susceptible to E.
coli. Additionally, the conclusion stated that
the etiology of urinary tract infections and
their susceptibility profiles are essential to
countries like Lebanon, where there is
frequent misuse of antibiotics. However, the
abstract did not state recommendations.
NO Comments and Evidences
“The purpose of this study was to investigate
the bacterial etiology of urinary tract infections
in one of the busiest hospitals of Lebanon and
to examine the epidemiologic and
microbiologic properties of Escherichia coli
isolated from urinary tract infections of
Lebanese patients over a 10-year period.”
(Verbatim po sa research)
The study followed the proper arrangement of
the research process, which included the
abstract, introduction, materials and methods,
results, and discussion, in a sequential
manner. It was logically written in which the
purpose and aims of the study corresponded
with the findings and conclusions that came
out. The researchers also provided valuable
related information from some published
articles that would aid in the discussion of the
results.
The literature review is logically organized
since it provided evidence for the current

● Is the review logically organized
and offers a balanced critical
analysis of the literature?
Theoretical Framework
● Is there an identified conceptual or
✓ studies use a conceptual or theoretical
theoretical framework?
● If yes, was it adequately described
and is the framework appropriate?
Aims/Objectives/Research
Question/Hypotheses
● Have aims and objectives, a
research question or hypothesis ✓
been clearly identified?
● If yes, are they clearly stated and
reflect the information presented in
the literature review?
study. The authors were also able to use
various resources to provide background
information about UTI, the prevalence rates,
its causative agents particularly bacteria,
treatment, and on how antibiotic resistance
increased over the years, which vary
depending on the environment. Furthermore,
the literature provided a balanced critical
analysis since the information from other
journals were used to support the ideas
mentioned in the study, and further expounded
in the discussion to come up with an answer to
the research questions. The literature review
was also used in the discussion of results,
since they compared their data to previous
studies since they included both hospital and
acquired UTI, providing better analysis and
explanation of the findings.
There was no theoretical framework identified
in the paper.
-----
V2
The authors did not specify a distinct
conceptual or theoretical framework. Most
framework to represent and proclaim possible
existing relationships between variables that
are being researched, compared, or linked to a
specific occurrence. Hence, defining and
establishing such frameworks to complement,
verify, and corroborate a study's findings is
critical.
It was stated clearly in the introduction section
of the paper that the study aims to analyze the
infectious epidemiology of UTIs and
susceptibility profiles of E. coli in a general
university hospital located in Beirut for 10
years, between the years 2000 and 2009.
V2
Yes, the aims and objective of the study was
evidently stated in the research article.

Sample/Population
● Has the target population been
clearly identified?
● How were the sample selected?
● Is it of adequate size?
● Are the inclusion/exclusion criteria
clearly identified?
Ethical Considerations
● Were the participants fully
informed about the nature of the
research?
● Was the confidentiality of the
participants guaranteed?
● Was ethical permission granted for
Located on page 1 of the study, under the
introduction section of the journal. The aims of
the study do reflect the information presented
in the literature review. It states that the
authors aim to determine the susceptibility
profiles of E. coli and provide the infectious
epidemiologic profiles of patients with UTI in
the Medical Laboratories of the Saint George
Hospital-University Medical Center in Beirut,
Lebanon during the year 2000 to 2009.
The target population has been clearly
identified. It was discussed in the materials
and methods part of the paper that the
population included all in- and outpatients with
UTIs. A total of 6,708 samples were taken
from female patients and 3,305 samples were
taken from male patients. It was revealed that
10,013 additional Gram(+) and Gram(-)
bacteria, in addition to C. albicans, were part
of the inclusion criteria. It was also stated that
only a single positive culture per patient within
three months was included.
✓ It was all stated in the study design under the
material and methods section. There it was
indicated that all the samples were taken from
the microbiology section of Saint George
Hospital-University in Beirut. It spanned a total
of 10 years and included all inpatients and
outpatients with urinary tract infection. There
were 6,708 samples from female patients and
3,305 samples from male patients. It was also
stated that only one positive culture for one
patient in a span of three months was
included. Since this was a retrospective study,
the sample size was adequate because they
included everyone who contracted UTI within
the 10-year span (2000-2009).
✔️ There was no mention of ethical
considerations in the study despite the
samples being from human samples.
 the study?
Study Design
● Is the research design clearly
identified?
Methodology
● Has the data gathering instrument
been described and is it
appropriate?
Data Analysis and Results
● Do the conclusions and discussion
reflect the calculated statistics
(example: mean, p values, or
confidence intervals)?
● Were the results presented clearly
and sufficiently to enable to draw
conclusions?
The study design was clearly identified to be a
retrospective study conducted at the
Microbiology section of the Medical
✔️
Laboratories of the Saint George Hospital-
University Medical Center, Beirut over the
course of ten years from 2000 to 2009.
✔️ The discussion and conclusion reflects the
calculated statistics within the study. In the
statistical analysis, variables were expressed
as percentages. It was stated that E. coli was
the predominant pathogen isolated from
patients with UTIs which is true based from the
results of the study wherein E. coli accounted
for approximately 61% of all clinically
significant urinary isolates and 76.8% of all
Enterobacteriaceae. It was also stated that
adult women have a higher prevalence of UTI
than men, which is supported by the results of
the study wherein the majority of pathogens
were isolated from women (69.8%). It was
then discussed that E. coli isolates from
urinary infections show more enhanced
susceptibility percentages and is coupled with
increasing ESBL production wherein all
cephalosporins activities are affected. These
are reflected by the results of the antibiotic
susceptibility profile of E. coli in urinary
isolates in comparison to hospital isolates.
Overall, the results were presented clearly
together with their respective subheadings and
tables, in order to better comprehend and to
draw out conclusions.
V2
The discussion and conclusion reflects the
calculated statistics obtained from the results.
The results were presented in tabular form and
were supported in the discussion. It was found

Conclusions
● Have the authors expressed the
effects of an intervention or
exposure in terms of the likely
benefit or harm which an individual
patient can expect?
● Do the authors’ conclusions match
the data, analysis, and statistical
significance?
out that the majority of pathogens were
isolated from women, around 69.8%.
Furthermore, E. coli accounted for
approximately 61% of all clinically significant
urinary isolates which is supported by previous
study that E. coli was the predominant
pathogen from patients with UTI. It was also
found out that Imipenem was the only
remaining antibiotic with 100% susceptibility
and Aminopenicillins no longer give
therapeutic treatment.
✔️ V1
The conclusion was drawn from the results
and discussion which reflected sufficient data
analysis through statistics and correlation with
previous existing literature. It was found out
that E. coli is the predominant pathogen
isolated from patients with UTI and it depicted
a similar pattern of susceptibility to those
isolated from other body site infections. E. coli
isolates showed simultaneous resistance to
third generation cephalosporins,
aminoglycosides, and fluoroquinolones.
Moreover, due to increasing ESBL production,
cephalosporins are challenged by inactivated
enzymes and aminopenicillin is not a
therapeutic alternative, making imipenem the
only antibiotic with 100% susceptibility against
UTI.
V2
The authors have expressed the importance of
evaluating the bacterial etiology of UTI and
their susceptibility profiles. Antibiotic
resistance still poses a health burden
especially with the increasing rates due to the
continuous, inappropriate use of antibiotics.
The conclusion is consistent with the findings
of the study where it reveals that E. coli was
the predominant pathogen isolated from UTI
patients. Moreover, E. coli isolates

Recommendations
✔️
● Was a recommendation for further
research made?
Clinical Impact Statement
● What is your perception of the
potential impact of the study on
your health care profession,
especially on your practice?
demonstrated simultaneous resistance to
third-generation cephalosporins,
aminoglycosides, and fluoroquinolones
whereas it showed 100% susceptibility to
imipenem.
V1
A few remarks could be taken as
recommendations from the authors and could
be used as a starting point for future
investigations. The authors mentioned that
their retrospective study conducted at the
Microbiology section of the Medical
Laboratories of the Saint George Hospital-
University Medical Center in Beirut does not
provide clinical data due to the fact that this
hospital receives patients from different areas
of Lebanon, and this may serve as a limitation
for the study. Also, according to the authors,
important information about symptomatic vs.
asymptomatic UTIs, complicated vs.
uncomplicated UTIs, and health-care-
associated vs. catheter-related UTIs could not
be addressed or discussed. This suggests that
future researchers interested in this topic
should look into and investigate material that
the authors were unable to include, as well as
information that may have been limited in the
study.
As a student of medical technology, , I believe
that this study is important since bacteria that
are resistant to antibiotics are already rampant
nowadays. Antibiotic resistant bacteria has a
huge impact because antibiotics are widely
used everywhere. As future healthcare
professionals, we must be aware of the
occurence of these types of bacteria to be able
to aid in the development of new antibiotics
against them.
References 

Coughlan, M., Cronin, P., & Ryan, F. (2007). Step-by-step guide to critiquing research. Part 1: quantitative
research. British Journal of Nursing (Mark Allen Publishing) , 16(11), 658–663.
https://doi.org/10.12968/bjon.2007.16.11.23681

Sullivan. (2008). Critical Appraisal for Research Papers Appraisal Checklist & Guide Questions .