Inducible clindamycin resistance among clinical Gram-positive cocci in a tertiary hospital in Niger Republic
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Thanks to the reviewers, your manuscript has been through extensive review and it is now ready to be accepted. Thank you for your patience while we completed our review and editorial processes.
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Comments to Author
Regarding manuscript ACMI-D-23-00162R2, second revision round. I am very embarrassed because I still find discrepancies between raw data and what is written in the main text of the manuscript. In their response to reviewer, the authors keep their numbers. Unless I have not been given the corresponding raw data, I still disagree on these points: (1) Line 100: there a 21 strains with no related data, this should be stated somewhere and then Response: We sincerely appreciate the reviewer's feedback on our manuscript and his meticulous data analysis. However, we respectfully disagree with the discrepancies noted by the reviewer when "comparing raw data and tables 1 and 2". The raw data had 100 Gram-positive cocci isolates and we did not find 21 strains with no related data in the raw data. >> in the …
Comments to Author
Regarding manuscript ACMI-D-23-00162R2, second revision round. I am very embarrassed because I still find discrepancies between raw data and what is written in the main text of the manuscript. In their response to reviewer, the authors keep their numbers. Unless I have not been given the corresponding raw data, I still disagree on these points: (1) Line 100: there a 21 strains with no related data, this should be stated somewhere and then Response: We sincerely appreciate the reviewer's feedback on our manuscript and his meticulous data analysis. However, we respectfully disagree with the discrepancies noted by the reviewer when "comparing raw data and tables 1 and 2". The raw data had 100 Gram-positive cocci isolates and we did not find 21 strains with no related data in the raw data. >> in the provided cocci dataset, I count 21 strains with NA data regarding bacteria, strains and so on, this needs to be counted in percentages (2) Table 1: In raw data, I count 47 CoNS strains, not 56, including 23 MR CoNS and 24 MS CoNS Response: While we appreciate the reviewer's feedback, we respectfully disagree with the discrepancies highlighted. As stated in the manuscript, 56 CoNS were analyzed, comprising 28 MRCoNS and 28 MSCoNS. >> in the provided cocci dataset, I count 47 CoNS strains, not 56, including 23 MR CoNS and 24 MS CoNS (3) Table 1: In raw data, I count 17 S. aureus strains, not 17, including 8 MRSA and 7 MSSA (not 9 and 8 as stated in table 1) Response: we also respectfully disagree with the discrepancies highlighted here. As stated in the manuscript, 17 S. aureus strains were analyzed, including 9 MRSA and 8 MSSA. >> in the provided cocci dataset, I count 15 S. strains not 17, including 8 MRSA and 7 MSSA
Please rate the manuscript for methodological rigour
Poor
Please rate the quality of the presentation and structure of the manuscript
Good
To what extent are the conclusions supported by the data?
Not at all
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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The reviewer has pointed out discrepancies in the raw data and the data presented - please address this point with the upmost care and attention to detail. Please respond to all points raised by the reviewer in a revised manuscript.
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Comments to Author
Major issue: Thank you for providing raw data. However, by comparing raw data and tables 1 and 2, I still note many discrepancies: - first of all, there a 21 strains with no related data, this should be stated somewhere and then percentage should be counted only on analysed strains, is it what is being done? - In raw data, I count 47 CoNS strains, not 56, including 23 MR CoNS and 24 MS CoNS - In raw data, I count 17 S. aureus strains, not 17, including 8 MRSA and 7 MSSA (not 9 and 8 as stated in table 1) My list is probably not exhaustive, so this needs to be carefully addressed for the next round of revision. In header of table 1, to what percentage do you refer to? total? Line 52: The provided link for raw data still does not work, I found data searching by name. They are located here:
Comments to Author
Major issue: Thank you for providing raw data. However, by comparing raw data and tables 1 and 2, I still note many discrepancies: - first of all, there a 21 strains with no related data, this should be stated somewhere and then percentage should be counted only on analysed strains, is it what is being done? - In raw data, I count 47 CoNS strains, not 56, including 23 MR CoNS and 24 MS CoNS - In raw data, I count 17 S. aureus strains, not 17, including 8 MRSA and 7 MSSA (not 9 and 8 as stated in table 1) My list is probably not exhaustive, so this needs to be carefully addressed for the next round of revision. In header of table 1, to what percentage do you refer to? total? Line 52: The provided link for raw data still does not work, I found data searching by name. They are located here: https://figshare.com/articles/dataset/_b_Niger_data_b_b_Inducible_clindamycin_resistance_b_/25466677 Minor issue: Table 2: - In the literature, for coagulase negative staphylococci, it seems CoNS is preferred to CoaNS - replace "sensible" by "susceptible"
Please rate the manuscript for methodological rigour
Poor
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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The reviewers have highlighted major concerns with the work presented. Please ensure that you address their comments.
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Comments to Author
Dear authors, Initially, I would like to congratulate you on the work you did. The methods used are appropriate and were well described in the manuscript. The results were presented clearly and with relevant illustrations, and the literature used is mostly from the last five years. Therefore, I only have minor revisions: 1) Consider changing some keywords so as not to repeat what is in the title; 2) What does "---" in the second section of the methodology mean?; 3) Figure 2 was not referenced in the results text.
Please rate the manuscript for methodological rigour
Good
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 …
Comments to Author
Dear authors, Initially, I would like to congratulate you on the work you did. The methods used are appropriate and were well described in the manuscript. The results were presented clearly and with relevant illustrations, and the literature used is mostly from the last five years. Therefore, I only have minor revisions: 1) Consider changing some keywords so as not to repeat what is in the title; 2) What does "---" in the second section of the methodology mean?; 3) Figure 2 was not referenced in the results text.
Please rate the manuscript for methodological rigour
Good
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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Comments to Author
The manuscript entitled " Inducible clindamycin resistance among clinical Gram-positive cocci in Niger Republic" is written good but the experiments performed to conclude the study is not enough. Introduction is well written. A short description for EUCAST guidelines can be included since it has been used as a standard throughout the paper. For study design setting and study period...it has been mentioned that the study was carried out between Jan and Dec but under what conditions and the individuals were does under any treatment or had any disease or infections...also, was there any other factors involved such due to exposure to clinical environment or any other factors. How did the study was selected for the gender and the age factor? In the line 109, there has been not mentioned the name of the …
Comments to Author
The manuscript entitled " Inducible clindamycin resistance among clinical Gram-positive cocci in Niger Republic" is written good but the experiments performed to conclude the study is not enough. Introduction is well written. A short description for EUCAST guidelines can be included since it has been used as a standard throughout the paper. For study design setting and study period...it has been mentioned that the study was carried out between Jan and Dec but under what conditions and the individuals were does under any treatment or had any disease or infections...also, was there any other factors involved such due to exposure to clinical environment or any other factors. How did the study was selected for the gender and the age factor? In the line 109, there has been not mentioned the name of the tests "Gram staining, coagulase and --- tests.". All the performed tests can be cited. To properly conclude the study hypothesis, antibiotic susceptibility profiling has to be performed in microtitre well broth dilution method to estimate the accurate concentration of the dosage being able to kill the bacteria. Also, to conclude the isolates are methicillin or any other antibiotic resistance, PCR based experiments need to perform to have proper evidence to support the hypothesis. In the graph, there is no error bar been mentioned in any of the graph.
Please rate the manuscript for methodological rigour
Poor
Please rate the quality of the presentation and structure of the manuscript
Satisfactory
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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Comments to Author
The manuscript entitled "inducible clindamycin resistance among Gram-positive cocci in Niger republic" by Yacouba et al describes the frequency of Gram-positive inducible clindamycin resistance in a tertiary care hospital in Niamey, Niger Republic. According to a recent review, data about clindamycin resistance among Gram-positive cocci are missing for Niger republic, so the article is timely. One hundred Gram-positive cocci strains were rigourously tested for clindamycin and clindamycin inducible resistance following EUCAST recommendations. However, data and percentages presented in tables need to be deeply revisited. major issues - Line 57: "The complete datasets are available online 57 at 10.6084/m9.figshare.24051063" Data provided (in 2020) when following the link do not seem to match with …
Comments to Author
The manuscript entitled "inducible clindamycin resistance among Gram-positive cocci in Niger republic" by Yacouba et al describes the frequency of Gram-positive inducible clindamycin resistance in a tertiary care hospital in Niamey, Niger Republic. According to a recent review, data about clindamycin resistance among Gram-positive cocci are missing for Niger republic, so the article is timely. One hundred Gram-positive cocci strains were rigourously tested for clindamycin and clindamycin inducible resistance following EUCAST recommendations. However, data and percentages presented in tables need to be deeply revisited. major issues - Line 57: "The complete datasets are available online 57 at 10.6084/m9.figshare.24051063" Data provided (in 2020) when following the link do not seem to match with strains and antibiotics data, please provide corresponding data - Line 172: 29.4% were both cMLSB and iMLSB > no, 29.4% were cMLSb and 29.4% were iMLSb? - Figure 1: -- legend is missing for y-axis in all barplots -- Since raw data for MS, S and cMLSb strains are missing, it's impossible to reconstitute accurate percentages for the reader For instance, for CoaNS, the barplot shows 8.9% iMLSb phenotypes in CoaNS strains (56 in total). In table 2, in row CoaNS, 6 strains out of 56 were found D-test positive, which makes 10.7%. Am I missing something? For S. aureus strains, in table 2, 4 strains out of 17 are found D-test +, which makes 23.5%. - Table 2: -- what is considered as a negative D-test, a S strain or a cMLSb strain? A strain can only be D-test negative or D-test positive, so in theory the sum of D-test negative and D-test positive should match with the number of strains in each category, but it's not the case. For instance, for CoaNS strains (56 as stated in table 1), 53 are D-test negative and 6 are D-test positive, which makes 59 strains, what are those 3 extra strains? For MRSA strains (9 as stated in table 1), 6 are D-test negative and 2 are D-test positive, why is one strain missing? Once again, without raw data, my interpretation may be wrong minor issue - Lines 44-47 and 48-54: Abbreviations need first to be precisely clarified, and then phenotype explained if needed iMLSb, inducible macrolide-lincosamide-streptogramin B (phenotype clindamycin sensitive and erythromycin resistant) cMLSb, constitutive macrolide-lincosamide-streptogramin B (phenotype clindamycin resistant and erythromycin resistant) - Line 61: reference 1 is only for urinary tract infections while stated human medicine - Line 66: reference 2 is not generalist, replace by a paper citing reference treatments praticals - Line 84 and 85: erm in italic - Line 93-97: missing reference paper for prevalence study numbers cited - Line 109 missing word ---tests- - Line 121: change "disc" to "discs" - Line 155: change to "were less than five-years old" - Line 157: urine was the most common specimen (77%) , why? does it reflect a general trend of inpatients of the Hopital National Amirou Boubacar Diallo? out of curiosity, prevalence of GPC among urinary infections? - Line 205 : "Gram-positive" for uniform spelling - Table 2: please indicate what is the number into parenthesis in D-test columns (I assume percentage, but relative to what, total strains?)
Please rate the manuscript for methodological rigour
Poor
Please rate the quality of the presentation and structure of the manuscript
Satisfactory
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
-
Comments to Author
I would like to thank the authors for the work spent on this manuscript, however, the are few remarks and comments that need to be addressed: - The title needs to be changed to specify that the work was done in a single hospital and a nationwide effort. - L19-20: Please re-phrase the sentence. - L31-33: Please re-phrase or spilt into two sentences to make it clearer. - L41: Is the graphical abstract necessary, if so, maybe move it into a supplementary material. - L67-70: Add appropriate references. - L78: Change 'literatures' to studies or articles. - L84-85: Please re-phrase the sentence. - L87-92: The claims in this paragraph are factually inaccurate and require references to support your claim. Standard practices in most clinical laboratories do detect ICR routinely. - L94-95: Add appropriate …
Comments to Author
I would like to thank the authors for the work spent on this manuscript, however, the are few remarks and comments that need to be addressed: - The title needs to be changed to specify that the work was done in a single hospital and a nationwide effort. - L19-20: Please re-phrase the sentence. - L31-33: Please re-phrase or spilt into two sentences to make it clearer. - L41: Is the graphical abstract necessary, if so, maybe move it into a supplementary material. - L67-70: Add appropriate references. - L78: Change 'literatures' to studies or articles. - L84-85: Please re-phrase the sentence. - L87-92: The claims in this paragraph are factually inaccurate and require references to support your claim. Standard practices in most clinical laboratories do detect ICR routinely. - L94-95: Add appropriate references and specify where in Africa. - L109: "and --- tests." What do you mean by this? - L203: "due his ability to" should be due to its ability to. - L205: should be "in Gram positive" and add appropriate references. - L214-215: Please re-phrase.
Please rate the manuscript for methodological rigour
Satisfactory
Please rate the quality of the presentation and structure of the manuscript
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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