First Molecular Identification of Three Clinical Isolates of Fungi Causing Mucormycosis in Honduras

Round 1

Reviewer 1 Report

I think the authors address most of my concerns. 

Author Response

Thanks.

This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.

Round 1

Reviewer 1 Report

The manuscript “First molecular identification of three clinical isolates of fungi causing mucormycosis in Honduras” reports the investigation three isolates resulting from serious or fatal cases of Mucormycosis (MM), corresponding to a pulmonary (PM), a rhino-orbital cerebral (ROCM), and a cutaneous Mucormycosis (CM). The ROCM and PM cases were morphologically identified as Rhizopus/Rhizomucor sp, and their causing microorganisms were then identified by DNA sequencing analysis as Rhizopus oryzae (or R. arrhizus) and R. oryzae/R. delemar. By the same analysis, the CM causing microorganism was identified as Apophysomyces ossiformis. This communication includes significant results on the application of molecular techniques to identify clinical isolates of fungi causing serious or fatal mucormycosis; I would recommend its publication after addressing the following minor issues.

Minor issues:

1. Keywords could be expanded to include all three fungi, “Mucorales”, “opportunistic fungal infections”, and “Coronavirus disease (COVID-19) associated mucormycosis”.
2. Section 2 could be divided in 2 sub-sections to separately describe fungi culture and identification from molecular analysis.
3. Section 2, lines 90-91. “ROCM” and “PM” abbreviations have been already introduced at lines 38-39.
4. Figure 1. In the g panel, ruler bands should be assigned in the figure to make the band characterization clearer.
5. Section 3, lines 155-157. The sentences could be joined as “The amplicons obtained from the PM clinical sample and the resulting amplicons from the three cultures were sequenced and analyzed using the NCBI BLAST tool.”
6. Section 3, line 159. “the PM” should be changed to “PM”.
7. Section 3, line 168. “group” should be “groups”.
8. Figure 2. The A panel should be enlarged to make it more readable.
9. Section 4, line 222-223. “12 of the patients” should be changed to “12 patients” and “That report” to “The report”.

Reviewer 2 Report

1. The references [2,4] of Line 37 and Line 39 are the same. Is that necessary?
2. In the introduction section, the authors use the references [2] (Line 27, Line 32, Line 37, Line 39, Line 47) and reference [4] (Line 37, Line 39, Line 43, Line 48, Line 50, Line 51) so many times. Please revise it.
3. Lines 68-70: “The methods available for the diagnosis of MM in most clinical laboratories are traditionally based on stains and cultures, which have technical and logistical limitations.” The authors should explain this sentence more detailed, especially “logistical limitations”
4. Lines 92-93, “The first and third patients presented the fungal infection in a post-COVID-19 stage.”. The authors should explain this sentence more detailed, and what’s the meaning of post-COVID-19 stage?
5. Figure 1 is too busy, and the size of each sub-image is not equal. Please revise it.
6. Line 146 line 148 mentioned “figure 1”. Please specifically point out which sub-image of Figure 1.
7. Line 210: Diabetes has been recognized as one of the main risk factors associated with MM, and more recently SARS-CoV-2 infections have been added to this list. Please add the reference to the statement.