Molecular Diagnosis of Two Major Implantation Mycoses: Chromoblastomycosis and Sporotrichosis

Round 1

Reviewer 1 Report

This is an interesting and useful study about diagnostics methods for identification of molds that cause chromoblastomycosis and sporotrichosis.

My major suggestions are - why not introduce the diseases in the introduction section rather than later in the paper.  Information about the numbers of cases and the geographic distribution would be help.  It would also be helpful to have more information about the current state of diagnostic testing in local hospitals. 

Information about feasibility and costs of the diagnostic tests would be useful.  I would guess that genome sequencing is out of the question, MALDI-TOF is very unlikely and LAMP would be the most feasible.  Using restriction enzyme patterns  (line 228) also seems to be beyond the ability of most clinical labs.

RCA is not defined in the text before being used in Table 1.

Should the list of primers be in a Supplemental Table?

Line 113 - substitute "large" for "high".

Line 114 space between "wells" and "in"

Author Response

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Author Response File: Author Response.docx

Reviewer 2 Report

In general, the manuscript is carried out correctly, it has order and the sections make it a quick read of the text.
There are some suggestions that will help the manuscript improve, I will comment on them shortly.

 

I suggest that in table 1 and in figure 1, put in the legends, what each of the abbreviations mentioned mean.
Also, some of the names of the microorganisms that appear in Figure 1, is the first time they appear in the text, for this reason, I suggest you put the full name of the organism.

 

On lines 53-59. I suggest you add the causative organism of that infection, as the pathogen that causes MBC is not mentioned so far.

 

lines 63-65: I suggest you restructure this part, it is not easy to understand if you mean CBM.

lines 74-575: I suggest you expand this information.

line 85: write the full name of the microorganism.

line 92: full name of Cdc 42.

line 102: Like which pathogenic species?

line 103: ITS one --> ITS1

line 110: reference of this method.

line 116: Cladophialophora carrionii --> C. carrioni

line 138: Like which? 

line 144: NIH (full name)

line 190: NCBI ibidem

line 228: fungi of the genus Sporothrix or Sporothrix spp.

line 229: reference.

line 229: What do you mean about temperature? expand the information.

line 230-231: Check this, because it is not necessarily by zoonotic transmission.

line 263: Are they in the process of being published or why were these data not published?

lines 274-281: I suggest making a comparative table of the enlargements generated in each species, it will be easier for the readers.

lines 311-314: Is there a reason why this part of the text is in italics?

Line 382: WHO: full name.

Author Response

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Author Response File: Author Response.docx

Reviewer 3 Report

In this manuscript the authors describe and discuss molecular diagnostic tests for chromoblastomycosis and sporotrichosis, the two main implantation mycoses. The manuscript is interesting, and well written. I have some comments that can help improve the masnuscript.

Chromoblastomycosis:
Figure 1. Has no legend
Include in a Table the sensitivity and specificity of molecular tests.
Discuss limitations of molecular tests

Sporotrichosis
Summarize in a table or figure, all diagnostic tests for sporotrichosis.
I suggest discussing the use of molecular testing for extracutaneous forms of sporotrichosis.
Compare the sensitivity and specificity of molecular tests. 

I suggest including a paragraph on the importance of molecular diagnosis of chromoblastomycosis and sporotrichosis from a public health perspective and the limitations that laboratories may have in implementing these molecular methods. This could serve as a basis for implementing these diagnostic methods at the care second level in endemic and hyperendemic areas of chromoblastomycosis and sporotrichosis.

Author Response

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