Surveillance of Bacterial Meningitis in the Italian Hospital of Desio: A Twenty-Year Retrospective Study

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The short Communication of Intra et al. is an interesting work presenting a needed update, especially for clinicians.

The abstract provides a concise overview of the study's objectives, methodology, and key findings. It highlights the significance of monitoring bacterial meningitis cases and the impact of vaccination strategies on the incidence rates of specific pathogens causing the disease.

The introduction effectively contextualizes bacterial meningitis as a significant global health concern, emphasizing its high morbidity and mortality rates. It outlines the common causative agents and the availability of vaccines against them. The importance of surveillance systems in tracking disease distribution and guiding prevention strategies is well-articulated.

The Mat. and methods section outlines the study's retrospective design, detailing the data collection process and laboratory procedures for identifying bacterial pathogens. The inclusion criteria for cases and the statistical analysis approach are clearly described, enhancing the transparency and reproducibility of the study. However, the MALDI-TOF database version(s) is not stated and should be.

Results and discussions presents the main findings of the study in a structured manner, discussing patient demographics, trends in bacterial meningitis cases over time, and the distribution of causative organisms. The impact of vaccination on reducing the incidence of specific pathogens is highlighted, supporting the effectiveness of vaccination programs.
While the discussion highlights the impact of vaccination on reducing the incidence of specific pathogens, it overlooks potential confounders and alternative explanations for the observed trends. Furthermore, the discussion lacks critical analysis of the limitations of the study, such as the retrospective design and the single-center setting, which may limit the generalizability of the findings. Conclusion provides a succinct summary of the study's key findings, emphasizing the role of vaccination in reducing bacterial meningitis cases and the importance of surveillance in monitoring disease trends. The limitations of the study are acknowledged, and suggestions for future research are briefly discussed.

I suggest a minor revision,  the MALDI-TOF databases used need to be presented as such databases are updated on an yearly base and it's an important factor, especially when talking about pathogen identifications across years.

Author Response

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Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

The article is interesting. I recommend expanding the discussion and comparing your results with other publications from Italy and the world. In addition, emphasize the importance of vaccination in the prevention of the main bacterial meningitis.

Author Response

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Author Response File: Author Response.pdf