Recent Trends in Antimicrobial Resistance among Anaerobic Clinical Isolates

Round 1

Reviewer 1 Report

The review paper of Reissier et al. deals with an iportant issue, the antimicrobial resistance properties of anaerobic pathogens and the mechanism behind those. The topic is current since the therapy is often based on empiric data. The manuscript brings well together our current knowledge which is huge beacuse of the number of such pathogens is high. It is well written but can be also  complemented at some parts. Additionally the authors do not use italic fonts for genus, species and gene names at some parts.

Specific comments

Lane 91: B. vulgatus is Phocaeicola vulgatus now

Lane 130: you can mention the novel crxA gene too (Soki et al. 2022; J Antimicrob Chemother 77: 1553-1556)

Lane 138: mobilzable transposon MTn4555

Lane 163: by an amino acid change

Lane 169: you can also mention the following work for cefoxitin resistance (Soki et al. 2011; J Antimicrob Chemother 66: 2492–2500)

Lane 188-190: it is not well known that an enzyme mediates the reduction, it can be done by interaction of the simple redoxpotentials of metronidazole and ferredoxin (Aluzet et al. 2019; Anaerobe 55: 40-53)

Lane 220: there are 12 nim decribed members now with nimL (Zurita et al. 2019; Microbiol Resource Announcements 8: e01125-01119)

Author Response

The review paper of Reissier et al. deals with an important issue, the antimicrobial resistance properties of anaerobic pathogens and the mechanism behind those. The topic is current since the therapy is often based on empiric data. The manuscript brings well together our current knowledge which is huge because of the number of such pathogens is high. It is well written but can be also complemented at some parts. Additionally the authors do not use italic fonts for genus, species and gene names at some parts.

Specific comments

Lane 91: B. vulgatus is Phocaeicola vulgatus now. The manuscript has been modified.

Lane 130: you can mention the novel crxA gene too (Soki et al. 2022; J Antimicrob Chemother 77: 1553-1556). The manuscript has been modified lane 171-173.

Lane 138: mobilzable transposon MTn4555. The manuscript has been modified.

Lane 163: by an amino acid change. The manuscript has been modified.

Lane 169: you can also mention the following work for cefoxitin resistance (Soki et al. 2011; J Antimicrob Chemother 66: 2492–2500). Thanks for your comment, the manuscript has been modified lane 161-163.

Lane 188-190: it is not well known that an enzyme mediates the reduction, it can be done by interaction of the simple redoxpotentials of metronidazole and ferredoxin (Aluzet et al. 2019; Anaerobe 55: 40-53). Thanks for your comment, in the attached reference, it is mentioned:

« In anaerobes, reduction occurs when metronidazole receives an electron from ferredoxin or flavodoxin that was reduced by the pyruvate ferredoxin/flavodoxin oxidoreductase (PFOR) system »

However, it has been recognized that other mechanisms can activate metronidazole such as: purified ferredoxin, flavodoxin, hydrogenase or suphite. (Dingsdag et al. J Antimicrob Chemother 2018; 73: 265–279). It has been chosen to refer to the Pfor system only with the adjective "principally" for the purpose of simplification.

Lane 220: there are 12 nim decribed members now with nimL (Zurita et al. 2019; Microbiol Resource Announcements 8: e01125-01119). Thanks for your comment, the manuscript has been modified.

Author Response File: Author Response.docx

Reviewer 2 Report

This paper aims to describe the evolution of antibiotic resistance among several anaerobes clinical isolates. The paper is well structured, however, I have some recommendations to improve this manuscript:

1. Please verify the italics for the bacteria names in the Introduction section. The majority of the species needs to be in italics (lines 32, 35, 36-39, 41, 65 etc).

2. Line 94 - here maybe is Belgium?

3. Line 120-121 -> here you can put Gram-negative and Gram-positive.

4. Line 260 - > here you reffer at B. fragilis group, maybe is more clear if you modify in this way. Also, please verify all the italics in the manuscript, there are many places where are required several modifications.

5. Line 356 - add space between words.

6. The conclusions section is too big, seems more a discution. Maybe you can considerate to add a discution section and to include in the conclusion section only a small part:

"In conclusion, antibiotic resistance in anaerobes is increasing worldwide and AST should be performed as far as possible to avoid therapeutic failure. More and more epidemiological and mechanistic data are published, and it seems important that laboratories continue to study anaerobes, to fully understand and prevent resistance in these bacteria."

The paper needs only minor English editing.

Author Response

This paper aims to describe the evolution of antibiotic resistance among several anaerobes clinical isolates. The paper is well structured, however, I have some recommendations to improve this manuscript:

1. Please verify the italics for the bacteria names in the Introduction section. The majority of the species needs to be in italics (lines 32, 35, 36-39, 41, 65 etc). The manuscript has been modified.
2. Line 94 - here maybe is Belgium? The manuscript has been modified.
3. Line 120-121 -> here you can put Gram-negative and Gram-positive. The manuscript has been modified.
4. Line 260 - > here you reffer at B. fragilis group, maybe is more clear if you modify in this way. Also, please verify all the italics in the manuscript, there are many places where are required several modifications. The manuscript has been modified to be clearer.
5. Line 356 - add space between words. The manuscript has been modified.
6. The conclusions section is too big, seems more a discution. Maybe you can considerate to add a discution section and to include in the conclusion section only a small part:

"In conclusion, antibiotic resistance in anaerobes is increasing worldwide and AST should be performed as far as possible to avoid therapeutic failure. More and more epidemiological and mechanistic data are published, and it seems important that laboratories continue to study anaerobes, to fully understand and prevent resistance in these bacteria." The manuscript has been modified.