Prognostic Impact of Nutritional Status in Patients with Candidemia

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The current study investigated the impact of nutritional status on prognosis in patients with candidemia and aimed to identify the most reliable nutritional assessment tool. A retrospective cohort of 170 patients (2014–2024) was included. The topic is clinically meaningful and potentially valuable. However, substantial revisions are required to improve the overall logical flow, methodological transparency, and scientific rigor before the manuscript can be considered for publication. My detailed comments are listed below:

1. Line 22: Please replace “Patients and Methods” with “Methods” to align with standard scientific writing conventions.
2. Lines 26–27: The sentence “A total of 170 patients were included, with a mean age of 73 years” should be moved to the Methods section, as it describes study population characteristics rather than background information.
3. Line 33: Please clarify what the “EQUAL Candida score” refers to. Provide the full name at first mention and briefly explain its components and clinical relevance.
4. Lines 63–68: Additional information is needed to explain how the referenced nutritional assessment tools function, what parameters they include, and why they may be relevant predictors of prognosis in candidemia patients.
5. Methods section:
   1. The total number of patients included in the study should be clearly stated at the beginning of the Methods section.
   2. The methodology lacks sufficient detail. For example, please clarify, the diagnostic criteria for candidemia; the Candida species identified; the microbiological methods used for blood culture confirmation
   3. …
6. Please specify the variables required to calculate each nutritional assessment score used in the study. A concise description or a supplementary table summarizing score components would improve clarity.
7. For abbreviations, please provide the full term at first mention (e.g., CRBSI, CVC, etc.) to improve readability and maintain standard reporting practice.
8. In Table 1, only male gender is presented. Please clarify the distribution of female patients and ensure that demographic variables are completely reported.
9. Several clinical and laboratory parameters were analyzed; however, the manuscript does not clearly justify why these specific variables were selected. Please provide rationale for their inclusion.
10. Some statistical analyses lack justification. For example, in Line 161, the comparison of overall survival between CONUT score ≥12 and <12 requires clarification. Why this comparison is needed and why was 12 chosen as the cutoff value?

Author Response

Manuscript ID: nutrients-4182143
Type of manuscript: Article
Title: Prognostic Impact of Nutritional Status in Patients with Candidemia

Dear Editor and Reviewer,

Thank you very much for taking the time to review our manuscript entitled “Prognostic Impact of Nutritional Status in Patients with Candidemia.”

 

We sincerely appreciate your valuable comments and suggestions. We fully agree with your observations and have revised the manuscript accordingly. The revised sections are highlighted in red in the manuscript for your convenience.

Your insightful feedback has been extremely helpful in improving the quality of the manuscript, and we believe that the revised version has been significantly strengthened.

We kindly ask you to reconsider the manuscript for publication in your esteemed journal.

Sincerely,

Nobuhiro Asai
March 7, 2026

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

This is an interesting paper, aiming to find any correlation between the nutritional stutus of the patient and the development of candidemia. It is a retrospective study [it is a limitation] 

By ansewring the following queries, I believe the paper to be improved in realation to its scientific volume

1. how many hospitalization days have past before diagnosis of candidemia
2. what was the number of admissions at the same time [2014-2024] not infectioned with Candida
3. Nutritional assessment was performed at admission or upon diagnosis? If upon diagnosis, it should be correlated with the time past and the nutrition treatment, the previous days. It should also be referred as study limitation
4. What was the method of nutrition of these patients [enteral, parenteral...]
5. do you know the number of different antibiotics they have the previous days received, and for how many days

Author Response

Manuscript ID: nutrients-4182143
Type of manuscript: Article
Title: Prognostic Impact of Nutritional Status in Patients with Candidemia

Dear Editor and Reviewer,

Thank you very much for taking the time to review our manuscript entitled “Prognostic Impact of Nutritional Status in Patients with Candidemia.”

 

We sincerely appreciate your valuable comments and suggestions. We fully agree with your observations and have revised the manuscript accordingly. The revised sections are highlighted in red in the manuscript for your convenience.

 

Your insightful feedback has been extremely helpful in improving the quality of the manuscript, and we believe that the revised version has been significantly strengthened.

 

We kindly ask you to reconsider the manuscript for publication in your esteemed journal.

 

Sincerely,

 

Nobuhiro Asai
March 7, 2026

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

The current version addressed my concerns and comments.

Reviewer 2 Report

Comments and Suggestions for Authors

thank you for your prompt reply to my comments

I understand that some of my comments were not able to by answered - to be written as study limitations is enough

to my part, your paper is OK for publication