Structured PREreview of First worldwide detection ofbla_IMP-15inStenotrophomonas maltophiliaisolated from a patient in Lebanon

Does the introduction explain the objective of the research presented in the preprint?

Yes

The authors report the first global identification of the blaIMP-15 gene in Stenotrophomonas maltophilia, an opportunistic, nosocomial, multidrug-resistant (MDR) Gram-negative bacterium. They provide some literature on the bacterium with no clearly stated objective, which implies the objective is to report and analyze the finding of this gene in this bacterium isolate.

Are the methods well-suited for this research?

Highly appropriate

The authors carried out antimicrobial susceptibility testing using Kirby-Bauer disk diffusion against 12 antimicrobials and one combination (ceftazidime-avibactam + aztreonam). They performed whole-genome sequencing using hybrid assembly (Illumina MiSeq short-read and Oxford Nanopore MinION long-read sequencing) and targeted validation by PCR amplification and confirmation via agarose gel electrophoresis and Sanger sequencing. The authors used the Comprehensive Antibiotic Resistance Database (CARD) and NCBI Antimicrobial Resistance Gene Finder in the identification of this AMR gene. These methods are appropriate and robust for identifying resistance genes and characterizing the isolate's antimicrobial susceptibility profile.

Are the conclusions supported by the data?

Somewhat supported

The authors did identify the blaIMP-15 gene in this isolate. They suggest potential transmissibility of blaIMP-15 in the abstract and discuss surrounding transposition elements (IS6100, ISPa382/383) in the last sections of the paper. Is this genetic context suggestive of horizontal gene transfer (HGT) potential? The manuscript would benefit from providing more detailed evidence or references demonstrating the transmissibility of blaIMP-15 in S. maltophilia and the potential involvement of these specific transposition elements. Also, the claim that IMP-15 reduces ceftazidime-avibactam efficacy (page 6, paragraph 2) lacks direct experimental evidence for this isolate. The authors should consider emphasizing the observed synergy between ceftazidime-avibactam and aztreonam as a potential alternative treatment option.

Are the data presentations, including visualizations, well-suited to represent the data?

Somewhat appropriate and clear

The data visualizations are clear but limited. The paper has a single table showing the antimicrobial susceptibility testing results of the isolate and a visual of the genomic placement of the blaIMP-15 gene with identified transposition elements.

How clearly do the authors discuss, explain, and interpret their findings and potential next steps for the research?

Somewhat clearly

The authors do clearly discuss the significance of detecting the blaIMP-15 gene in this S. malptophilia isolate, however, they could provide more context on potential next steps such as exploring its transmissibility in this bacterium and its impact on treatment strategies. Future studies should also consider investigating experimentally, how blaIMP-15 impacts the efficacy of ceftazidime-avibactam alone versus combination therapies and assess the additional resistance conferred by this gene in combination with the blaL1 gene.

Is the preprint likely to advance academic knowledge?

Highly likely

Yes, the preprint is likely to advance academic knowledge. The identification of the blaIMP-15 gene in S. maltophilia contributes to understanding the evolving landscape of antimicrobial resistance.

Would it benefit from language editing?

No

No language editing issues. The authors should consider revising the “and” in the statement “Genome annotation was done using and Prokka (v1.14.6) (15)” on page 4, paragraph 1, line 4.

Would you recommend this preprint to others?

Yes, it’s of high quality

This preprint is relevant to researchers with interest in AMR, S. maltophilia and carbapenemase-producing bacteria.

Is it ready for attention from an editor, publisher or broader audience?

Yes, as it is

Competing interests

The authors declare that they have no competing interests.