Clinical and genomic features of a Listeria monocytogenes fatal case of meningitis in Madagascar
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Listeriosis constitutes a significant public health threat due to its high mortality rate. This study investigates the microbiological and genomic characteristics of Listeria monocytogenes isolates in Madagascar, where listeriosis is a notifiable disease. The analysis focuses on a fatal case of meningeal listeriosis in a 12-year-old child. Genomic analysis revealed a novel cgMLST type (L2-SL8-ST8-CT11697; CC8, serogroup Iia) with typical virulence and antibiotic resistance profiles. These isolates, unique to Madagascar, formed an independent clade in the phylogenetic tree. This study presents the first genomic characterization of Listeria isolates in Madagascar, highlighting the necessity of ongoing genomic surveillance to strengthen listeriosis prevention and control strategies in the region.
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The work presented is clear and the arguments well formed. Many thanks for your work and congratulations on your publication! You have presented a well-structured manuscript and addressed the reviewers' comments wonderfully. Looking forward to future contributions.
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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
Please maintain formatting throughout the manuscript. Line 73 - What do you mean by "simple" Lines 77-78 - Do you have values to depict the biochemical profile of the CSF? Perhaps they can be included in parentheses with units to quantify the information for the reader Lines 79-80 - What do you mean by a meningitis identification kit? What is this? Please clearly explain what does this kit entail and the principles on which it functions. Is it a PCR looking at multiple targets of CNS pathogens? Line 81 - You say "appropriate" treatment, but for Listeria, amoxicillin would be first line due to inherent resistance to cephalosporins and poor clinical outcomes with glycopeptides. Was there a reason amoxicillin was not used? Did the cultures take too long to return information? Was antimicrobial …
Comments to Author
Please maintain formatting throughout the manuscript. Line 73 - What do you mean by "simple" Lines 77-78 - Do you have values to depict the biochemical profile of the CSF? Perhaps they can be included in parentheses with units to quantify the information for the reader Lines 79-80 - What do you mean by a meningitis identification kit? What is this? Please clearly explain what does this kit entail and the principles on which it functions. Is it a PCR looking at multiple targets of CNS pathogens? Line 81 - You say "appropriate" treatment, but for Listeria, amoxicillin would be first line due to inherent resistance to cephalosporins and poor clinical outcomes with glycopeptides. Was there a reason amoxicillin was not used? Did the cultures take too long to return information? Was antimicrobial susceptibility testing performed? Line 92 - Which both? Please be clearer. Line 99 - The new type differs by 12 alleles from L2…CT750 - Where is this isolate found? Is it the common isolate worldwide? Can a better-quality Figure be uploaded, difficult to ascertain the clade from such a miniscule tree. Was the source of Listeriosis determined? Was Public Health involved?
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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Comments to Author
Line 62: ' The Among the 107', may be delete 'The'? Line 66-71: The format should be consistent. Line 68: Italics should be used with 'Listeria monocytogenes'. Line 79-80：The 'meningitis identification kit' was used for identify Listeria monocytogenes with q-PCR? What do you mean? The author should describe the method. There is no 'Methods' part in this manuscript. Line 82-84: Only described using microscopy, MALDI-TOF MS, but did not show any results. Besides, the author should annotate which machine was used and what database. Line 81-82:Did you complete the relative 'Antibiotic susceptibility testing'？It would be useful for treatment. What's the reference or guidance for this sentence 'appropriate treatment with ceftriaxone, gentamicin, and vancomycin'? Line 92: 'Both L. monocytogenes …
Comments to Author
Line 62: ' The Among the 107', may be delete 'The'? Line 66-71: The format should be consistent. Line 68: Italics should be used with 'Listeria monocytogenes'. Line 79-80：The 'meningitis identification kit' was used for identify Listeria monocytogenes with q-PCR? What do you mean? The author should describe the method. There is no 'Methods' part in this manuscript. Line 82-84: Only described using microscopy, MALDI-TOF MS, but did not show any results. Besides, the author should annotate which machine was used and what database. Line 81-82:Did you complete the relative 'Antibiotic susceptibility testing'？It would be useful for treatment. What's the reference or guidance for this sentence 'appropriate treatment with ceftriaxone, gentamicin, and vancomycin'? Line 92: 'Both L. monocytogenes isolates'，which both? The author should express clearer. Line 104: The figure is not very clear. I cannot conclude the meaning the author said at line 101-103.
Please rate the quality of the presentation and structure of the manuscript
Poor
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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