Profile of Bacteria Isolated from the Cell Phones of Health Care Providers in a Hospital Setting in Cameroon

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The presented work presents an interesting topic of contamination of medical staff phones. Although this may be an outdated topic for many hospitals, I think it is important information for Cameroon. The study used simple methods for identifying microorganisms collected from the surface of phones. Pathogenic microorganisms have been classified as species. In the future, it may be worth determining the drug susceptibility of these strains to better understand their characteristics? Although the subject of the work is interesting, the manuscript has a few errors which are listed below.

1. Please check the references carefully and prepare according to the recommendations.
2. Please write down all species names of bacteria that appear for the first time in full name.
3. In the title without a dot at the end
4. Line 78 - without "1st"
5. Subtitles - in italics
6. The unit is always written after a space - line 116,117 - "42.2 g", "1000 mL", etc.
7. Line 137 - please write that the paragraph concerns the MacConkey substrate
8. Line 139: "conditions:"

9. Line 166 - "(p=0.05)."
10. Line 182 - "(Figure 1)."
11. Please standardize the font in Figure 1.
12. Line 185 - please move to line 184, after ";"
13. Lines 187-189 Italics.
14. Table 1 - columna 3 - in one column.
15. Line 198 - "n - frequency; % - percentage"
16. Line 214 - space
17. Line 215 - the
Line 239 - E. - italics
18. Line 249 - complete the subtitle.

19. Please supplement the introduction with information about pathogenic microorganisms that were present on the respondents' phones.

20. What biochemical tests were used for identification?
21. Was human blood used to prepare the media?

Author Response

ANSWERS

Open Review 1

 

Comments and Suggestions for Authors

The presented work presents an interesting topic of contamination of medical staff phones. Although this may be an outdated topic for many hospitals, I think it is important information for Cameroon. The study used simple methods for identifying microorganisms collected from the surface of phones. Pathogenic microorganisms have been classified as species. In the future, it may be worth determining the drug susceptibility of these strains to better understand their characteristics? Although the subject of the work is interesting, the manuscript has a few errors which are listed below.

1. Please check the references carefully and prepare according to the recommendations……..Done (see updated version of the manuscript)
   2. Please write down all species names of bacteria that appear for the first time in full name…..Completed
   3. In the title without a dot at the end……..Corrected
   4. Line 78 - without "1st"…….Corrected
   5. Subtitles - in italics…….Corrected
   6. The unit is always written after a space - line 116,117 - "42.2 g", "1000 mL", etc…….Adjusted
   7. Line 137 - please write that the paragraph concerns the MacConkey substrate……Precised
   8. Line 139: "conditions:"…….Corrected
2. Line 166 - "(p=0.05)."……. Corrected
   10. Line 182 - "(Figure 1)."………Removed since that result appeared to be a duplication of the result presented in the table.
   11. Please standardize the font in Figure 1…..The figure was cancelled
   12. Line 185 - please move to line 184, after ";"….Adjusted
   13. Lines 187-189 Italics…………corrected
   14. Table 1 - columna 3 - in one column……..Column adjusted, table 1 became table 3. Some results were omitted
   15. Line 198 - "n - frequency; % - percentage"….Adjusted
   16. Line 214 – space……..Corrected
   17. Line 215 – the Line 239 - E. – italics…..Adjusted
   18. Line 249 - complete the subtitle……”And” was removed
3. Please supplement the introduction with information about pathogenic microorganisms that were present on the respondents' phones.

Dhayhi et al. [7] in Saudi Arabia, has found notable pathogens including Escherichia coli, Klebsiella pneumoniae, Pseudomonas species and Acinetobacter species on cellphones of health staff in critical care unit……. see lines 58-60 in the manuscript.

20. What biochemical tests were used for identification?

Bacteria isolated in this study were done by biochemical tests (Catalase, Coagulase, Oxidase and Indole tests) and gram staining….see lines 158-159 in the manuscript.

 

21. Was human blood used to prepare the media?

Yes, 25 mL of fresh Human blood gotten from blood bank was used to prepare the media… see lines 125-126 in the manuscript.

NB: All areas of additions and adjustments are highlighted in yellow color in the updated manuscript.

Author Response File: Author Response.doc

Reviewer 2 Report

Comments and Suggestions for Authors

In the present manuscript, the authors have attempted to depict microbial populations isolated from cell phones of health care workers. The authors aim to generate awareness of potential spread of nosocomial pathogens through cell phones and have also provided recommendations to prevent the transmission. Unfortunately, I felt that the content of the manuscript is incomplete and lacks substantive value. A lot of manuscripts have been published that explore similar hypotheses with elaborate experimental designs and in-depth analysis of the findings. The present manuscript does not carry enough impact for the journal. On that account, I must recommend rejection for this manuscript.

Comments for author File: Comments.pdf

Author Response

Open Review 2

 

Comments and Suggestions for Authors

In the present manuscript, the authors have attempted to depict microbial populations isolated from cell phones of health care workers. The authors aim to generate awareness of potential spread of nosocomial pathogens through cell phones and have also provided recommendations to prevent the transmission. Unfortunately, I felt that the content of the manuscript is incomplete and lacks substantive value. A lot of manuscripts have been published that explore similar hypotheses with elaborate experimental designs and in-depth analysis of the findings. The present manuscript does not carry enough impact for the journal. On that account, I must recommend rejection for this manuscript.

Feedback:

Some results from the work have been added, some recent references too, to complete substantive value of the manuscript that will impact the journal……see updated manuscript

NB: All areas of additions and adjustments are highlighted in yellow color in the updated manuscript.

Author Response File: Author Response.doc

Reviewer 3 Report

Comments and Suggestions for Authors

The authors present a manuscript profiling the bacteria present in cell phones in hospital setting.

1) The manuscript is very similar to a previous publication according to the ithenticate report, so I please ask the author to check this and please re-write accordingly.

2) Is there a reason for the lack of recent references? If so, please explain, if not, please find updated references for background and discussion.

3) Please provide details for the statistical analysis for comparisons, the authors include p-values but do not mention the test and comparisons performed. Did you compare multiple variables at the time with post hoc tests or paired comparisons? Please provide more information.

4) Analysis showed the abundant presence of CoNS; however, there are several CoNS with clinical relevance as opportunistic pathogens? Did you analyze in detail which CoNS are present? Please discuss more about the relevance of this group of bacteria.

5) The authors mention the following: " The fact that cell phone of females staff are more infected than for male can be explained by the fact that females staff are more attached to their cell phones than their male counterparts" and provide a citation that references adolescent studies. I ask the authors to either provide further support for this claim and the claim in the paragraph or find an alternative proposal. 

6) Starting on line 250 the authors mention that laboratory personnel show a higher prevalence rate compared to other professions. However, in table 2 there is no significant differences between groups. Please address this inconsistency. 

 

 

 

Comments on the Quality of English Language

Although the manuscript can be read without major complications, the redaction of the manuscript can be improved. e.g. line 227-229. 

Also, the usage of plurals and other minor details can be improved to enhance the quality of the manuscript. 

Please revise.

Author Response

ANSWERS

Open Review 3

 

Comments and Suggestions for Authors

The authors present a manuscript profiling the bacteria present in cell phones in hospital setting.

1) The manuscript is very similar to a previous publication according to the ithenticate report, so I please ask the author to check this and please re-write accordingly.

Some results from the work have been added, some recent references too, to complete and enhance the quality of the manuscript

2) Is there a reason for the lack of recent references? If so, please explain, if not, please find updated references for background and discussion.

Some recent references have been added to discuss the results so to complete substantive value of the manuscript

3) Please provide details for the statistical analysis for comparisons, the authors include p-values but do not mention the test and comparisons performed. Did you compare multiple variables at the time with post hoc tests or paired comparisons? Please provide more information.

The results were presented in frequencies and proportions. Chi square test was used to compare proportions between variables and the results were considered statistically significant when p < 0.05….inserted in the manuscript.

4) Analysis showed the abundant presence of CoNS; however, there are several CoNS with clinical relevance as opportunistic pathogens? Did you analyze in detail which CoNS are present? Please discuss more about the relevance of this group of bacteria.

The scope of this study was limited in the identification of the bacteria on the cellphones of health care providers. CoNS. However, the CoNS identified in this study of nosocomial importance include Staphylococcus epidermidis and Staphylococcus haemolyticus.

5) The authors mention the following: " The fact that cell phone of females staff are more infected than for male can be explained by the fact that females staff are more attached to their cell phones than their male counterparts" and provide a citation that references adolescent studies. I ask the authors to either provide further support for this claim and the claim in the paragraph or find an alternative proposal. 

The cell phones of female staff were found to be more contaminated than those of male staff. This result is contrary to the one obtained by Amala et al. [14] in Nigeria and similar to the one obtained by Yao et al. [15] in China. The fact that cell phone of females staff are more infected than for male can be explained by the fact that females staff are more attached to their cell phones than their male counterparts [16]…..Adjusted, see the manuscript

6) Starting on line 250 the authors mention that laboratory personnel show a higher prevalence rate compared to other professions. However, in table 2 there is no significant differences between groups. Please address this inconsistency. ….

Sorry, it was a typing mistake that induced the error…it is ”0” instead of “9”

Mobile phones of laboratory workers were found to be significantly contaminated with bacteria compared to those of nurses/midwives and medical doctors (p = 0.003) (Table 4)……see the updated manuscript.

 

 

Comments on the Quality of English Language

Although the manuscript can be read without major complications, the redaction of the manuscript can be improved. e.g. line 227-229……Adjusted…see Line 289 - 291 

Also, the usage of plurals and other minor details can be improved to enhance the quality of the manuscript……improved….see the updated manuscript  

Please revise………Done….see the updated manuscript

 

NB: All areas of additions and adjustments are highlighted in yellow color in the updated manuscript.

 

Author Response File: Author Response.doc

Round 2

Reviewer 2 Report

Comments and Suggestions for Authors

With the updates in the revised manuscript, it is recommended to be accepted.

 

Author Response

Reviewer 2 With the update in the revised manuscript it is recommended to be accepted Reply Thanks very much

Reviewer 3 Report

Comments and Suggestions for Authors

The authors have addressed most of the comments from the previous version. However, I ask them for more corrections before final publication.

1) Please include more specific details about the statistics. E.g. in the analysis where they analyzed more than two variables, please make sure to include which variables were compared, and found statistically significant.

2) What decontamination methods were used? Are all consistent? Is there a significant difference between decontamination methods?

3) Although not analyzed in detail, please mention the CoNS that were identified in this study, as you did in the reply.

4) Although, the authors included more details about the gender differences (female), they mention that the results they found are similar to previous studies, and also contrast previous studies. Please discuss in detail how they are different and similar and why this could be. In Yao N. et al, they found that female users have "cleaner phones". 

 

Author Response

Reviewer 3 1) Please include more specific details about the statistics. E.g. in the analysis where they analyzed more than two variables, please make sure to include which variables were compared, and found statistically significant. Answer The analysis indicated that based on the presence and absence of bacteria on the cell phones of participants, gender was found to be statistically associated with having bacteria on the cellphone or not (p=0.007). Belonging to the female gender was a predisposing factor to having bacteria on the cellphone. Occupation of healthcare providers (Laboratory personnel, nurses/midwives and medical doctor) was found to be significantly associated (p=0.033) with bacteria present or absent on their cellphones. Our results show that being laboratory personnel increased the likelihood to have bacteria on the cellphone. The number of years of work experience was found to be statistically associated with the presence or absence of bacteria on the cellphone of healthcare personnel (p=0.002). Cellphones of staff with less than 5 years of work experience was more contaminated. Level of education was found also to be statistically associated with the presence or absence of bacteria on the cellphone of health personnel (p