Prevalence of Escherichia coli Producing Extended Spectrum Beta-Lactamase (ESBL) Driven Septicaemia in Children Aged 0–2 Years in Two Districts Hospitals in Yaounde, Cameroon
, Rodrigue Kamga Wouambo 3, Suzie Titsamp Lacmago 1, Audrey Dayomo 1, Hortense Gonsu Kamga 4, Benjamin D. Thumamo Pokam 5 and Teke Apalata 6Round 1
Reviewer 1 Report
The manuscript entitled "Prevalence of Escherichia coli producing extended spectrum beta-lactamase (ESBL) driven septicemia in children aged 0 - 2 years in two districts hospitals in Yaounde and Cameroon" publishes the results of studies of E. coli samples taken from children's blood as part of a clinical trial of septicemia in Cameroon. The study of this topic is extremely important and is not only of scientific interest, but also of great public importance. The methodology is described quite competently, which makes it possible to judge that the study was performed correctly. The conclusions are confirmed by the results, the sample is sufficient. The text is written sequentially, but the article as a whole is brief, it could be filled with fresh literary data, perhaps add author's photos illustrating the results of the study. It is recommended to accept the article after minor changes.
1) Line 125. There is too much free space not occupied by the text at the end of the page.
2) Line 31, 127, 129, 126, 135. There is no space in "E. coli".
3) Lines 49, 127, 209, 220, 222, 233. The name of the bacterium should be written in italics.
4) Line 131. The dot at the end of the sentence is missing.
5) Line 104. It would make sense to add photos of inhibition zones obtained using disco diffusion analysis.
6) Chapter 2.8. Does it make sense to publish this information?
7) The right part of Figure 1 is not entirely clear. If the authors wanted to show 34%, then it would be necessary to divide the diagram into two colors or use another technique. Here, the diagram is colored in one color, which, apparently, should be changed.
8) In Chapter 3.4. Table 1 is not explained clearly enough. It is desirable to describe in more detail what the factors in the left column mean. The same applies to Table 2.
9) Lines 156-159. Is the presence of E. coli in the blood an unambiguous evidence of septicemia?
10) It makes sense to expand the literature review a little by adding a number of references to studies conducted after 2020.
Author Response
Review Report Form
Open Review
(x) I would not like to sign my review report
( ) I would like to sign my review report
English language and style
( ) English very difficult to understand/incomprehensible
( ) Extensive editing of English language and style required
(x) Moderate English changes required
( ) English language and style are fine/minor spell check required
( ) I don't feel qualified to judge about the English language and style
|
Yes |
Can be improved |
Must be improved |
Not applicable |
|
|
Does the introduction provide sufficient background and include all relevant references? |
( ) |
(x) |
( ) |
( ) |
|
Are all the cited references relevant to the research? |
(x) |
( ) |
( ) |
( ) |
|
Is the research design appropriate? |
( ) |
(x) |
( ) |
( ) |
|
Are the methods adequately described? |
( ) |
(x) |
( ) |
( ) |
|
Are the results clearly presented? |
( ) |
(x) |
( ) |
( ) |
|
Are the conclusions supported by the results? |
(x) |
( ) |
( ) |
( ) |
Comments and Suggestions for Authors
The manuscript entitled "Prevalence of Escherichia coli producing extended spectrum beta-lactamase (ESBL) driven septicemia in children aged 0 - 2 years in two districts hospitals in Yaounde and Cameroon" publishes the results of studies of E. coli samples taken from children's blood as part of a clinical trial of septicemia in Cameroon. The study of this topic is extremely important and is not only of scientific interest, but also of great public importance. The methodology is described quite competently, which makes it possible to judge that the study was performed correctly. The conclusions are confirmed by the results, the sample is sufficient. The text is written sequentially, but the article as a whole is brief, it could be filled with fresh literary data, perhaps add author's photos illustrating the results of the study. It is recommended to accept the article after minor changes.
Answer: Dear reviewer, Thank very much for your positive comments and suggestions. We completely review the manuscript with track changes, taking into account your inputs from the introduction to the conclusion.
- Line 125. There is too much free space not occupied by the text at the end of the page.
Answer: Thanks dear reviewer, we reduced free space as requested
- Line 31, 127, 129, 126, 135. There is no space in "E. coli".
Answer: Thanks dear reviewer, we reduced free space as requested
- Lines 49, 127, 209, 220, 222, 233. The name of the bacterium should be written in italics.
Answer: Thanks dear reviewer, done as suggested
- Line 131. The dot at the end of the sentence is missing.
Answer: Thanks dear reviewer, corrected as suggested
- Line 104. It would make sense to add photos of inhibition zones obtained using disco diffusion analysis.
Answer: Unfortunately dear reviewer, we have no photos, considering that the study was carried out about 2 years ago, those performing the lab work did not recall to have snap that. We understand that this would have been interesting.
6) Chapter 2.8. Does it make sense to publish this information?
Answer: Thanks dear reviewer, we simply removed it.
7) The right part of Figure 1 is not entirely clear. If the authors wanted to show 34%, then it would be necessary to divide the diagram into two colors or use another technique. Here, the diagram is colored in one color, which, apparently, should be changed.
Answer: Thanks dear reviewer, we improved it as requested.
8) In Chapter 3.4. Table 1 is not explained clearly enough. It is desirable to describe in more detail what the factors in the left column mean. The same applies to Table 2.
Answer: Thanks dear reviewer, we improved it as requested.
9) Lines 156-159. Is the presence of E. coli in the blood an unambiguous evidence of septicemia?
Answer: Thanks dear reviewer, we the study was conducted on symptomatic neonates admitted in neonatal unit. So, we corrected the sentence.
10) It makes sense to expand the literature review a little by adding a number of references to studies conducted after 2020.
Answer: Thanks dear reviewer, we did it
Reviewer 2 Report
"Prevalence of Escherichia coli producing extended spectrum beta-lactamase (ESBL) driven septicemia in children aged 0 - 2 3 years in two districts hospitals in Yaounde and Cameroon" is an simplistic article of medium novelty, but still, of high importance due to the raw as well as statistical data provided.
I would strongly suggest changing the article type to "Short Communication".
The title is good however the Abstract is complicated in an unnecessary manner. The abstract should be reduced in a more concise and fluent form stating only the essential.
Introduction
Line 49: " One person dies from septicemia in the world every 3-4 seconds and its incidence varies from 50 1 to 5 per 1000 live births [3]" Reference 3 dates from 2012!, please provide updated data.
It needs to be highlighted that there are very few references for a topic so vast and important. Please provide more, sufficient citations.
Line 65: "notwithstanding in 2013 resistance to gentamycin was as high as 43.9 %" yet again, please provide updated data
Results
Line 119: "Equally, 77.66% (233/300) were immunocompromised" explain why or what is considered "immunocompromised"
Line 157: "A recent study in Niger found a similar high" is there a link between Niger, China, Abidjan and England (where antibiotics are strictly regulated) are you referring strictly to E coli or to antibiotics resistance? Please give fundament to this statement.
Conclusions
Are too brief, expand by detailing the current situation, possible causes and correlations.
Author Response
Open Review
(x) I would not like to sign my review report
( ) I would like to sign my review report
English language and style
( ) English very difficult to understand/incomprehensible
( ) Extensive editing of English language and style required
( ) Moderate English changes required
( ) English language and style are fine/minor spell check required
(x) I don't feel qualified to judge about the English language and style
|
Yes |
Can be improved |
Must be improved |
Not applicable |
|
|
Does the introduction provide sufficient background and include all relevant references? |
( ) |
( ) |
(x) |
( ) |
|
Are all the cited references relevant to the research? |
( ) |
( ) |
(x) |
( ) |
|
Is the research design appropriate? |
( ) |
(x) |
( ) |
( ) |
|
Are the methods adequately described? |
( ) |
(x) |
( ) |
( ) |
|
Are the results clearly presented? |
(x) |
( ) |
( ) |
( ) |
|
Are the conclusions supported by the results? |
( ) |
(x) |
( ) |
( ) |
Comments and Suggestions for Authors
"Prevalence of Escherichia coli producing extended spectrum beta-lactamase (ESBL) driven septicemia in children aged 0 - 2 3 years in two districts hospitals in Yaounde and Cameroon" is an simplistic article of medium novelty, but still, of high importance due to the raw as well as statistical data provided.
Answer: Dear reviewer, Thank very much for your inputs. We went through your comments and suggestions one after the other and modified the manuscript accordingly,
I would strongly suggest changing the article type to "Short Communication".
Answer: Dear reviewer, Thank for your comment. However, we would gladly like it to be considered as a research paper.
The title is good however the Abstract is complicated in an unnecessary manner. The abstract should be reduced in a more concise and fluent form stating only the essential.
Answer: Dear reviewer, Thank very much for your comment, we shorted the abstract as requested
Introduction
Line 49: " One person dies from septicemia in the world every 3-4 seconds and its incidence varies from 50 1 to 5 per 1000 live births [3]" Reference 3 dates from 2012!, please provide updated data.
It needs to be highlighted that there are very few references for a topic so vast and important. Please provide more, sufficient citations.
Answer: Dear reviewer, Thank very much for your comment, we updated and added more relevant references as requested.
Line 65: "notwithstanding in 2013 resistance to gentamycin was as high as 43.9 %" yet again, please provide updated data
Answer: Dear reviewer, we have corrected
Results
Line 119: "Equally, 77.66% (233/300) were immunocompromised" explain why or what is considered "immunocompromised"
Answer: Dear reviewer, Thanks for this question. In fact, further informations were collected in child records after consultation by the pediatricians. All infants living with HIV, those with recurrent infections, and admitted infants undergoing blood transfusion were considered as immunocompromised.
Line 157: "A recent study in Niger found a similar high" is there a link between Niger, China, Abidjan and England (where antibiotics are strictly regulated) are you referring strictly to E coli or to antibiotics resistance? Please give fundament to this statement.
Answer: Dear reviewer, the study in Niger and our study had an almost similar overall rate of blood culture positive in neonate (55, 1% and 43, 33 % respectively) and we have cited studies conducted in Abidjan and England in reference to E. coli prevalence.
Conclusions
Are too brief, expand by detailing the current situation, possible causes and correlations.
Answer: Thanks dear reviewer, Main findings have been highlighted and we wished not to expand further to avoid redundancy with the discussion.
