Case report: isolation of Hydrogenophaga from septic blood culture following near-death drowning in lakewater
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A patient suffered a non-fatal wet drowning in a freshwater lake and developed bacteraemia several days later. Blood culture grew a Gram-negative rod that could not be identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). 16S ribosomal RNA sequencing of the isolate identified the microbe as Hydrogenophaga laconesensis – an environmental microbe commonly found in freshwater. The recovery of multiple pathogenic micro-organisms (although not H. laconesensis ) from culture of respiratory specimens prompted the initiation of antibiotic therapy with cefepime and, later, vancomycin. The patient’s clinical course gradually improved over the course of 2 weeks and she was ultimately discharged home with minimal sequelae. To our knowledge, this is the first evidence of human infection with bacteria in the genus Hydrogenophaga . Hydrogenophaga may be considered in cases of freshwater near-drowning, and MALDI-TOF MS databases should be updated to include H. laconesensis .
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I am pleased to tell you that your article has now been accepted for publication in Access Microbiology. The work presented is clear, well written and contributes to the literature. Thank you for addressing all reviewers comments satisfactorily and in a timely manner.
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Thank you for submitting your revised manuscript for publication in Access Microbiology. After reviewing the manuscript, I'm happy that all reviewer's comments have been addressed. However, some minor changes are needed to include: 1. For completeness/clarity, please add a statement to the manuscript addressing why co-infection is unlikely and bacteremia was caused by the organism isolated from blood cultures (response to reviewer 1) 2. Line 23: MALDI-TOF MS in full in abstract 3. Hydrogenophaga laconesensis in full for first use in abstract and introduction and then can refer to as H. laconesensis 4. Figure 1: update figure to either highlight both Hydrogenophaga flava and Hydrogenophaga pseudoflava in the table or have neither highlighted Editor Review Questions Respons
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Comments to Author
The manuscript titled "Case report: isolation of Hydrogenophaga from septic blood culture following near-death drowning in lakewater" by Feichtinger et al. have isolated Hydrogenophaga strain from the blood of a patient who drowned and developed bacteraemia. The manuscript is well written and I complement the authors. Please find my comments below: 1. The authors claim that the infection or bacteraemia is due to the bacterium Hydrogenophaga, but they failed to demonstrate that the infection is strictly due to this species. Further, so far isolated species of the genus Hydrogenophaga are from fresh water habitats and the chances of being infectious are extremely rare. 2. Authors should have carried out in vitro (using cell lines) and/or in vivo (using animal models) studies, using the isolated strain, …
Comments to Author
The manuscript titled "Case report: isolation of Hydrogenophaga from septic blood culture following near-death drowning in lakewater" by Feichtinger et al. have isolated Hydrogenophaga strain from the blood of a patient who drowned and developed bacteraemia. The manuscript is well written and I complement the authors. Please find my comments below: 1. The authors claim that the infection or bacteraemia is due to the bacterium Hydrogenophaga, but they failed to demonstrate that the infection is strictly due to this species. Further, so far isolated species of the genus Hydrogenophaga are from fresh water habitats and the chances of being infectious are extremely rare. 2. Authors should have carried out in vitro (using cell lines) and/or in vivo (using animal models) studies, using the isolated strain, to support their claim. 3. The manuscript is concentrated more on the case description, diagnostic assessment and clinical course than on their main claim of proving that strain Hydrogenophaga is the causative of bacteraemia (especially when they claim that the strain is non-haemolytic). Thus the present work is too naïve and do not recommend for publication.
Please rate the quality of the presentation and structure of the manuscript
Good
To what extent are the conclusions supported by the data?
Partially support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
Yes
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Thank you for submitting your manuscript for publication in Access Microbiology. It has been examined by expert reviewers who have concluded that the work is of potential interest to the readership of Access Microbiology. However, based on the comments received, it is clear that a major revision of this manuscript will be required before a decision can be made on its publication. I will be pleased to consider a revised manuscript along with a document including a point by point response to each of the reviewers comments. Furthermore, it is important to address the limitations of this study in the discussion as you have not proven that the organism isolated caused the disease. Discussions around future work is also required e.g. in vivo and in vitro studies may be useful to characterise the virulence of the isolate. Your revised …
Thank you for submitting your manuscript for publication in Access Microbiology. It has been examined by expert reviewers who have concluded that the work is of potential interest to the readership of Access Microbiology. However, based on the comments received, it is clear that a major revision of this manuscript will be required before a decision can be made on its publication. I will be pleased to consider a revised manuscript along with a document including a point by point response to each of the reviewers comments. Furthermore, it is important to address the limitations of this study in the discussion as you have not proven that the organism isolated caused the disease. Discussions around future work is also required e.g. in vivo and in vitro studies may be useful to characterise the virulence of the isolate. Your revised manuscript may be returned to one or more of the original reviewers, along with your itemised response to the reviewers’ comments. I look forward to receiving the revised manuscript.
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Comments to Author
This is a useful and mostly well-written "Case report". The report contains new information and makes a strong recommendation that can easily be implemented. I therefore have only the most minor suggestions for improvements to the text. However, there are at least four very long sentences that initially I mis-read. I advise splitting three of them into two sentences and one of them, lines 62 to 69, into three sentences. The paper should then be accepted immediately for publication. My suggestions are therefore as follows. L22. Surely all "drowning" by definition involves water - so delete "wet". L 42. Replace dove with dived. L62 Full stop after closing the bracket: start a new sentence. L65 - 69. Split into 2 sentences. L77. Full stop after database:. Start a new sentence. L95 Replace the …
Comments to Author
This is a useful and mostly well-written "Case report". The report contains new information and makes a strong recommendation that can easily be implemented. I therefore have only the most minor suggestions for improvements to the text. However, there are at least four very long sentences that initially I mis-read. I advise splitting three of them into two sentences and one of them, lines 62 to 69, into three sentences. The paper should then be accepted immediately for publication. My suggestions are therefore as follows. L22. Surely all "drowning" by definition involves water - so delete "wet". L 42. Replace dove with dived. L62 Full stop after closing the bracket: start a new sentence. L65 - 69. Split into 2 sentences. L77. Full stop after database:. Start a new sentence. L95 Replace the semicolon with a full stop, New sentence starting However….
Please rate the quality of the presentation and structure of the manuscript
Very good
To what extent are the conclusions supported by the data?
Strongly support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
Yes
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