PONE-D-20-05280

Pathogenic Spectrum of Blood Stream Infections and Resistance Pattern in Gram-Negative Bacteria

PLOS ONE

Dear Dr Bandy,

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Grzegorz Woźniakowski, PhD ScD

Academic Editor

PLOS ONE

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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: Yes

Reviewer #2: Yes

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

Reviewer #1: Yes

Reviewer #2: No

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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?

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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: Pathogenic Spectrum of Blood Stream Infections and Resistance Pattern in Gram-Negative Bacteria

The study conducted by authors presents data about blood strain infection bacteria profiles and their antibiotic resistance. Analysis of samples (n=222) collected from hospitals in Saudi Arabia (Aljouf region) revealed valuable information of types of bacteria (advantage of Gram negative) their genus (K. pneumoniae, E. coli, A. baumannii) and their antbiotic response profile.

Authors indicated, that bacteria originated from every geographic region may differ in antibiotic resistance. In light of this, work done by authors presents a novelty.

Paper is well organised and presents reliable data supported by other studies. However I suggest several minor remarks:

1. If it is possible please specify the region (country) in the title of manuscript

2.

a) lines 68-70: The pathogenic spectrum and pattern of antimicrobial resistance of BSIs

differ across the affected regions owing to the differences in epidemiological and geographic features across regions

b) line 77: In Saudi Arabia, 29% of Escherichia coli strains produce […]

c) line 78-79: In the sentence „For Klebsiella pneumoniae, this rate is 65%, and the reported mortality caused by these organisms remains high” please indicate percentage of mortality rate

d) Table 2, sections Age and Microorganisms: please sort data from the highest to lowest as in the other sections

e) Table 4: Whenever it’s possible I suggest to avoid commercial names of antibiotics such (i.e. Augmentin) and focus on active substances: amoxicillin and clavulanate potassium etc.

f) Table 4, section Tygecycline: According to data shown in the table there was 3 resistant cases which is 17,6% of all cases, and there was no sensitive strains at all (0 –in the table). Where is 82,4% cases? Could you explain that?

I recommend to publish this paper after applying indicated remarks.

Reviewer #2: The manuscript presents interesting data on Pathogenic Spectrum of Blood Stream Infections and Resistance Pattern in Gram-Negative Bacteria. However, i have the following observations.

1. The use of abbreviations in the abstract should be corrected.

2. The data can be explored further by applying non-parametric statistics such as Chi square especially in Table 2 (where applicable). That way the difference between the groups can be better appreciated instead of the percentages. In such cases, provide the p-values deduced as well.

3. There are a lot of result repetitions in the discussion. Also, the discussions are un-conclusive; stating that the values are higher or lower than previous studies alone does not suffice, reasons should be given e.g is it due to variations in sample size, evaluation methods as so on. The entire discussion should be re-written based on this.

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Reviewer #1: No

Reviewer #2: No

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Pathogenic spectrum of blood stream infections and resistance pattern in Gram-negative bacteria from Aljouf region of Saudi Arabia

PONE-D-20-05280R1

Dear Dr. Bandy,

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,

Grzegorz Woźniakowski, PhD ScD

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

Reviewer #2: 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

Reviewer #2: Yes

**********

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

Reviewer #1: Yes

Reviewer #2: N/A

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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

Reviewer #2: Yes

**********

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

Reviewer #2: 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: Dear Author

Thank you for applying indicated remarks.

I've got no further comments.

I recommend to publish manuscript.

Kind regards.

Reviewer #2: (No Response)

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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: No

Reviewer #2: No