PONE-D-19-30829

Asymptomatic bacteriuria among pregnant women attending antenatal care at Mbale hospital, Eastern Uganda.

PLOS ONE

Dear Prof Kiondo,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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Both reviewers note some interest in this manuscript but have suggested necessary revisions that need to be made. I think that writing a more substantial Introduction section is of particular importance.

In addition to the points noted by the reviewers I would like you to consider the following points:

In the "Selection of participants" section it reads as if only every third woman who had "accepted to join" the study was used in the present analysis. Please clarify as to whether this is true. If it is true, were the 2/3 women not used in the present analysis used in other studies that were running at the same time? At present this seems rather wasteful of recruits.

Do you know if any of the women had either pre-existing or gestational diabetes? Could glycosuria have influenced your findings?

In addition please provide some information about the BMI of the study participants.

In the "Data Collection Procedures" section, why were further tests performed for Enterobacteriaceae counts less than 10,000 Cfu/ml, but not for other potential bacterial infections?

In Table 1 the "Married" is a simple binary yes or no. Were any of the study participants co-habiting?

In Table 2 the p-values do not agree for the 20-24 age group in comparison to the <20 group, in the main text of the Table and the text below it.

The section title "ANTIICROBIAL SUSCEPTIBILITY OF THE ISOLATES" contains a typographical error.

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We look forward to receiving your revised manuscript.

Kind regards,

Clive J Petry, PhD

Academic Editor

PLOS ONE

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1. In your Methods section, please provide additional information about the participant recruitment method and the demographic details of your participants. Please ensure you have provided sufficient details to replicate the analyses such as: a) the recruitment date range (month and year), b)  a clear description of how sample size was calculated (at the moment, it is not clear why the parameters used were adopted), and c) a clear description of the "assets and amenities" considered to determine socioeconomic status, and and explanation on why these are not included in Table 1.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: -The introduction is too short and authors did not identify other literature enough on the topic with no explaining of how the study relates to previously published research in the area. Also, references are not uptodate with most of the references more than 10 years ago.

-The study is a screening one with no details on the mechanisms of resistance found in their isolates (perhaps some more details as simple gene detection by PCR would be ).

-Ethical approval is mentioned twice.

-The authors should put bacterial isolation and antimicrobial susceptibility testing under a new heading other than "data Collection".

-Fosfomycin is an important antimicrobial usually used for urinary tract infection (perhaps it would be better if the authors test for its action).

-Table one misses a footnote.

- Ref 15 is for a study carried on children, how is it comparable to the current study!

-Resistance to beta-lactam antibiotics is not only due to ESBL production as stated by the authors in the last paragraph.

Reviewer #2: Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) (Limit 200 to 20000 Characters)

Could you please see my attached review, I have added all my comments to the Author in an attachment.

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Reviewer #1: Yes: Noha A Hassuna

Reviewer #2: No

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Attachments

Attachment

Submitted filename: Reviewers comments.pdf

Asymptomatic bacteriuria among pregnant women attending antenatal care at Mbale hospital, Eastern Uganda.

PONE-D-19-30829R1

Dear Dr. Kiondo,

We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements.

Within one week, you will receive an e-mail containing information on the amendments required prior to publication. When all required modifications have been addressed, you will receive a formal acceptance letter and your manuscript will proceed to our production department and be scheduled for publication.

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With kind regards,

Clive J Petry, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The manuscript has improved. Authors have responded to previous corrections. All responses meet formatting specifications.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Noha A Hassuna