Colonization and Healthcare-Associated Infection of Carbapenem-Resistant Enterobacteriaceae, Data from Polish Hospital with High Incidence of Carbapenem-Resistant Enterobacteriaceae, Does Active Target Screening Matter?

Round 1

Reviewer 1 Report

Pawlowska et al. present their single center study where they implemented an active surveillance program which targeted the isolation of carbapenem-resistant Enterobacteriaceae. The authors performed culture in specific media, they performed bacterial identification and antimicrobial susceptibility testing, phenotypic tests and PCR analysis for the detection of carbapenemase genes. The authors performed also statistical analysis.

In general, the manuscript is well written and I only have minor comments and suggections to make.

Abstract

Please replace the word occurrence with the word incidence.

Introduction

The authors should emphasize in this point that the problem of carbapenem-resistant Enterobacteriaceae is more intense in endemic countries. The authors should use in this point the Reference of Karampatakis et al. Molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae in Greece. Future Microbiol. 2016 Jun;11:809-23.

Discussion

In this section the authors should emphasize the importance of the proper implementation of infection control measures to diminish the colonization rates of carbapenem-resistant Gram-negative bacteria. In this point the authors should use the Reference of Karampatakis et al. Impact of active surveillance and infection control measures on carbapenem-resistant Gram-negative bacterial colonization and infections in intensive care. J Hosp Infect. 2018 Aug;99(4):396-404

Author Response

As suggested, we have introduced the necessary changes according to reviewers’ suggestions and comments. In our opinion, the readability of the manuscript has greatly improved, due to the suggestions from reviewer. Enclosed with the cover letter, please find the point-by-point replies to the reviewers’ comments. All changes in revised manuscript were yellow highlighted.

Reviewer #1, Round 1:

Pawlowska et al. present their single center study where they implemented an active surveillance program which targeted the isolation of carbapenem-resistant Enterobacteriaceae. The authors performed culture in specific media, they performed bacterial identification and antimicrobial susceptibility testing, phenotypic tests and PCR analysis for the detection of carbapenemase genes. The authors performed also statistical analysis. In general, the manuscript is well written and I only have minor comments and suggestions to make.

Authors’ reply: Thank you for this comment!

Abstract: Please replace the word occurrence with the word incidence.

Authors’ reply: Corrected according to suggestions.

Introduction: The authors should emphasize in this point that the problem of carbapenem-resistant Enterobacteriaceae is more intense in endemic countries. The authors should use in this point the Reference of Karampatakis et al. Molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae in Greece. Future Microbiol. 2016 Jun;11:809-23.

Authors’ reply: Corrected according to suggestions, lines: 57-61 and reference list.

Discussion: In this section the authors should emphasize the importance of the proper implementation of infection control measures to diminish the colonization rates of carbapenem-resistant Gram-negative bacteria. In this point the authors should use the Reference of Karampatakis et al. Impact of active surveillance and infection control measures on carbapenem-resistant Gram-negative bacterial colonization and infections in intensive care. J Hosp Infect. 2018 Aug;99(4):396-404

Authors’ reply: Corrected according to suggestions, lines: 237-239 and reference list.

Reviewer 2 Report

The manuscript is interesting foccusing in an important aspect as antimicrobial resistance in bacterial isolated from hospital patients. Some minor revisions are needed.

Title: Please do not include abbreviations in the title. (HAI and CRE)

Figure 2: The authors have to indicate the meaning of the abbreviations in the figure.

Line 118: What statistical test was performed?

Line 137,138 and 139: Please indicate the meaning of CR-UTI and CR-LRT and CR-SSI.

Line 140: Please delete = in Klebsiella

Line 143: Avoid starting a sentence with a number.

Line 144: Delete :

Author Response

As suggested, we have introduced the necessary changes according to reviewers’ suggestions and comments. In our opinion, the readability of the manuscript has greatly improved, due to the suggestions from reviewer. Enclosed with the cover letter, please find the point-by-point replies to the reviewers’ comments. All changes in revised manuscript were yellow highlighted.

Reviewer #2, Round 1:

The manuscript is interesting focusing in an important aspect as antimicrobial resistance in bacterial isolated from hospital patients. Some minor revisions are needed.

Authors’ reply: Thank you for this comment!

Title: Please do not include abbreviations in the title. (HAI and CRE)

Authors’ reply: Corrected according to suggestions.

Figure 2: The authors have to indicate the meaning of the abbreviations in the figure.

Authors’ reply: Corrected according to suggestions.

Line 118: What statistical test was performed?

Authors’ reply: Corrected according to suggestions, corrected according to suggestions, lines: 122-125.

Line 137,138 and 139: Please indicate the meaning of CR-UTI and CR-LRT and CR-SSI.

Authors’ reply: Corrected according to suggestions, lines: 1445-149.

Line 140: Please delete = in Klebsiella

Authors’ reply: Corrected according to suggestions, lines: 150-151.

Line 143: Avoid starting a sentence with a number.

Authors’ reply: Corrected according to suggestions.

Line 144: Delete :

Authors’ reply: Corrected according to suggestions.