Early Staphylococcal Periprosthetic Joint Infection (PJI) Treated with Debridement, Antibiotics, and Implant Retention (DAIR): Inferior Outcomes in Patients with Staphylococci Resistant to Rifampicin

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This report presented  DAIR with rifampicin resistance staph was poorer result than rifampicin sensitive one.

There is a big confounder such as a period after index surgery. As you mentioned, biofilm formation begins from 2-6 weeks after inoculation. The results of before and after  biofilm formation may be different even rifampicin resistance. 

Please analyze and discuss the period of index surgery to DAIR and infection relapse.

Please add information about duration of index surgery to DAIR in the Table.

Please abbreviate  the Journal name: #2,5,8,10,14,19,45,53,75

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

In this manuscript, the relationship between rifampicin resistance of staphylococci in periprosthetic joint infection (PJI) treated by debridement, antibiotics and implant retention (DAIR) was studied.

The following comments are made:

 

1. Line 42. Staphylococcus aureus is written in italics and abbreviated as S. aureus. Correct throughout the text.

2. Lines 77-80. You could specify the antibiotics and doses used.

3. Line 120. “infection relapse after one DAIR procedure”. Does it involve infections with S. aureus or just CoNS? Indicate it.

4. Solutions to the problem are not contemplated in the discussion. Discuss what options there would be for both the use of antibiotics and treatment to solve the problem studied.

5. In section 4, say how you identified S. aureus and CoNS

6. Also indicate how you detected that the strains were resistant or sensitive to rifampicin in more detail.

7. Did you detect the presence of biofilm? If the answer is yes, how did you do it? If the answer is no, why didn't you do it?

8. Also indicate the antibiotic treatment administered completely.

Comments on the Quality of English Language

The quality of English is satisfactory

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

The author has systematically conducted all the experiment and results and discussions were thoroughly explained. I think it will have significant impact on Journals readership.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

I have a few relatively minor comments, explained below.

Please abbreviate the Journal Name: #4,7,10,16,21,47,55,77.

 

Author Response

Author response: Thank you for this clarification. We have updated the manuscript accordingly, please see the reference section.

Reviewer 2 Report

Comments and Suggestions for Authors

1. You still do not put Staphylococus aureus in italics. Also, the abbreviation should be S. aureus, not S. Aureus. Correct throughout the text.

2. Lines 77-81. Indicate why the doses are variable.

3. Lines 224-229. Indicate what causes the variability in treatment.

Comments on the Quality of English Language

The quality of English is acceptable

Author Response

1. You still do not put Staphylococus aureus in italics. Also, the abbreviation should be S. aureus, not S. Aureus. Correct throughout the text.

Author response: Thank you for this correction. We misunderstood. We have now updated the manuscript accordingly.

2. Lines 77-81. Indicate why the doses are variable.

Author response: Thank you for your suggestion. We have addressed this in page 2, lines 76-77.