Leclercia adecarboxylata in Peritoneal Dialysis Patients: A Systematic Review
, Vasiliki Karava 1, Georgia Sotiriou 1, Athina Papadopoulou 1, Charalampos Zarras 2, Chrysi Michailidou 2, Eleni Vagdatli 2 and Nikoleta Printza 1Round 1
Reviewer 1 Report
This is an interesting case report of still rare cause of peritonitis in PD patients. Authors reported 13 of such cases, including their own experience. I don’t have any major comments, since it is accurate and well presented.
Some minor comments:
In paragraph describing Case Report, in line 70 the patients is as “she”, elsewhere is always he/male.
In the same paragraph the sentence “From the antimicrobial agents tested, was found to be sensitive at all.” (lines 61-62) seems not correct, I supposed it should be to all?
In line 76 with link to prosperio there is unnecessary space after underscore, which return as an error on a website.
In the results section, line 139, there is incorrect range for children age, should be 5 not 2.
Author Response
Dear editor,
On behalf of my co-authors I thank you for your letter regarding our above mentioned manuscript containing the comments of the reviewers. Based on the recommendations of the reviewers we have modified the manuscript and we now submit the revised manuscript. Our responses point-by-point are shown below.
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Leclercia Adecarboxylata in Peritoneal Dialysis Patients: A Sys-2 tematic Review
The manuscript entitled “Leclercia Adecarboxylata in Peritoneal Dialysis Patients: A Systematic Review” by Dotis et al., is an exciting study. The author carried out a systematic review of all the relevant reported cases in the literature. Leclercia adecarboxylata is a gram negative bacillus that can cause infections in humans. Authors recently treat peritonitis due to L. adecarboxylata in peritoneal dialysis (PD) pediatric patients and by reviewing the literature they found that L. adecarboxylata infections could be under-reported due to the high degree of phenotypic overlap between L. adecarboxylata and E. coli strains. This pathogen seems to be insensitive or sensitive to most antimicrobial agents, however, healthcare providers should have all these in mind when treating patients with infections caused by this uncommon microorganism, in order to achieve a favorable outcome
Overall, the information presented in this research article is useful for the researchers and I approve its publication after some minor updates.
Minor comments: I suggest that these comments be updated before publication.
For the clinical studies – the case report or the methods section should have information about the year/time of sample collection like is it during the visit? How severe the condition was and how many days stayed at the hospital?
In the study section, for the current study articles instead of mentioning till 31 October 2022, the starting and ending times should be mentioned. It is also better to mention whether the literature was published in index journals or non-index journals.
Author Response
Dear Editor,
On behalf of my co-authors I thank you for your letter regarding our above mentioned manuscript containing the comments of the reviewers. Based on the recommendations of the reviewers we have modified the manuscript and we now submit the revised manuscript. Our responses point-by-point are shown below.
Author Response File: Author Response.pdf
Reviewer 3 Report
This study highlights the potential under-reporting of L. adecarboxylata infections due to phenotypic overlap with E. coli strains. The pathogen appears to be sensitive to most antimicrobial agents, but healthcare providers should consider this when treating patients with infections caused by this uncommon microorganism to achieve a favorable outcome.
Overall, it is well conceptualized with a minor flaws:
1. The study included only 13 cases of peritonitis due to L. adecarboxylata, which may not be sufficient to draw definitive conclusions or make generalizations about the management of this condition. This should be mentioned in the discussion.
2. The study relied on published case reports, which may not reflect the true incidence or prevalence of peritonitis due to L. adecarboxylata. It is possible that cases with unfavorable outcomes were not reported or were not published in the languages searched in this study.
3. Since this is a case series study, there is no comparison group to evaluate the effectiveness of the treatment strategies used in this study. Therefore, it is difficult to determine if the outcomes were solely due to the treatment provided or other factors.
4. The study did not perform any statistical analysis to evaluate the significance of the findings. Therefore, it is unclear if the treatment strategies used were effective or if the outcomes were simply due to chance.
Author Response
Dear Editor,
On behalf of my co-authors I thank you for your letter regarding our above mentioned manuscript containing the comments of the reviewers. Based on the recommendations of the reviewers we have modified the manuscript and we now submit the revised manuscript. Our responses point-by-point are shown below.
Author Response File: Author Response.pdf
