Ocular Bacterial Infections: A Ten-Year Survey and Review of Causative Organisms Based on the Oklahoma Experience
, Md Huzzatul Mursalin 1, Phillip S. Coburn 1, Erin T. Livingston 2, James W. Nightengale 1, Eddy Bagaruka 3, Jonathan J. Hunt 3 and Michelle C. Callegan 1,2,4,*Round 1
Reviewer 1 Report
Roger A. Astley and co-authors present a quality and well-written manuscript describing ocular bacterial infections: a ten-year survey and review of causative organisms based on the Oklahoma experience.
Authors present a survey of ocular bacterial isolates and review of ocular pathogens that is based on a survey of a collection of isolates gathered over a ten-year span at the Dean McGee Eye Institute in Oklahoma. These findings illustrate the diversity of bacteria isolated from the eye, ranging from common species to rare and unique species. At all sampled sites, staphylococci were the predominant bacteria isolated. Pseudomonads were the most common Gram-negative bacterial isolate, except in vitreous where Serratia was the most common Gram-negative bacterial isolate.
Authors discuss the range of ocular infections that these species have been documented to cause and treatment options for these infections. Although a highly diverse spectrum of species has been isolated from the eye, the majority of infections are caused by Gram-positive species, and in most infections, empiric treatments are effective.
Finally, authors conclude that ocular infections of any kind are not trivial inconveniences to those who suffer from them. Even a self-limiting case of bacterial conjunctivitis can result in lost wages, time lost from school, parental time away from work, and the social stigma of an unsightly contagious ocular infection. Because of the delicate nature and great importance of ocular tissues, medical care must be prompt and effective.
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Other comments:
1) Please check for typos throughout the manuscript.
2) With regards to Serratia marcescens microorganism – authors are kindly encouraged to cite the following article that describes specific enzymatic activity for S. marcescens. This is relevant for fighting infections in mucous parts of human body. DOI: 10.3389/fphar.2018.00114
Author Response
1. Please check for typos throughout the manuscript.
Done and corrected, thank you.
2. With regards to Serratia marcescens microorganism – authors are kindly encouraged to cite the following article that describes specific enzymatic activity for S. marcescens. This is relevant for fighting infections in mucous parts of human body. DOI: 10.3389/fphar.2018.00114
This paper has been added to the manuscript (new #240).
Reviewer 2 Report
Summary: Astley and coworkers provide a comprehensive review of 903 ocular bacterial isolates over a 10-period period (2011 – 2021) at the McGee Eye Institute in Oklahoma City, Oklahoma. A great diversity of bacteria ranging from common to rare and unique were identified with information on anatomic location of collection indicated. These ranged from cornea, conjunctiva, and eye lid to vitreous, aqueous humor, and anterior chamber to lacrimal gland and even contact lens. Of these, Staphylococcus and Streptococcus were the most frequently isolated Gram-positive bacteria and Pseudomonas was the most frequently isolated Gram-negative bacteria.
Review: This is a well written review that provides a comprehensive survey of bacterial isolates from patients with ocular eye infections that spanned 10 years at a leading eye institute within the United States, i.e., the McGee Eye Institute in Oklahoma City, Oklahoma. The review is nicely accompanied by several reader-friendly tables and figures, and each bacterial isolate is discussed in some depth that will be helpful to amateur bacteriologists and clinicians interested in ocular disease of bacterial origin. Moreover, an impressive and valuable list of references is included. Although the review enjoys many strengths, attention to a few suggestions might further strengthen this otherwise important addition to the ophthalmologic literature.
1. The first paragraph seems greatly out-of-place. Indeed, the review should begin with paragraph two that is a general overview of the eye and places the importance of the review in its proper perspective. The first paragraph could be deleted because the last paragraph of the Introduction includes the information found within the first paragraph.
2. Were there cases of multiple bacterial infections with two or more different bacterial species in some cases?
3. The authors might comment on any significant advances in the area of ocular bacteriology that probably took place over the 10-year collection period reported in this review that might relate to better recovery and/or better identification of a particular bacterial isolate in the clinical setting.
Author Response
- The first paragraph seems greatly out-of-place. Indeed, the review should begin with paragraph two that is a general overview of the eye and places the importance of the review in its proper perspective. The first paragraph could be deleted because the last paragraph of the Introduction includes the information found within the first paragraph.
This was a short and apparently unnecessary Methods section that was separate from the Introduction when we submitted the paper. That separation may have been lost on formatting. We agree and have deleted the paragraph and added some of this information to the middle of the paragraph starting with “The data presented below…” on page 2, line 65.
- Were there cases of multiple bacterial infections with two or more different bacterial species in some cases?
Because patient and case data were not available, we are unable to answer this question.
- The authors might comment on any significant advances in the area of ocular bacteriology that probably took place over the 10-year collection period reported in this review that might relate to better recovery and/or better identification of a particular bacterial isolate in the clinical setting.
We mentioned the use of cutting-edge genomics to shorten diagnostic times in the second paragraph of section 6 (Conclusions). Based on this concern, we expanded on this idea in the same paragraph starting with line 889 on page 23.
