Prevalance of inducible clindamycin resistance of Staphylococcus aureus from various clinical specimens by D test in tertiary care hospital

chudasama, Dr Vyoma; Solanki, Dr. Hasumati L.; Vadsmiya, Minesh G; Vegad, Dr M M

doi:10.9790/0853-13312932

Cited by 3 publications

(6 citation statements)

References 6 publications

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“…Constitutive clindamycin resistance in our study was observed in 7.5% of MSSA and 25% of MRSA isolates, which is similar to Majhi et al, (2016) and Chudasama et al, (2014). Truly clindamycinsensitive isolates, which exhibit MS phenotype, were present in 14.38% of MSSA and 9.68% of MRSA isolates in our study.…”

Section: Resultssupporting

confidence: 78%

Inducible Clindamycin Resistance among Clinical Isolates of Staphylococcus aureus in a Tertiary Care Hospital, Nanded, Maharashtra, India

More¹,

Rathod²,

Khan³

2017

Int.J.Curr.Microbiol.App.Sci

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Section: Resultssupporting

confidence: 78%

Inducible Clindamycin Resistance among Clinical Isolates of Staphylococcus aureus in a Tertiary Care Hospital, Nanded, Maharashtra, India

More¹,

Rathod²,

Khan³

2017

Int.J.Curr.Microbiol.App.Sci

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“…(54.78%). [ 15 16 17 ] Lyall et al . had reported a very high percentage of MRSA (91.5%) in their study.…”

Section: Discussionmentioning

confidence: 99%

“…In different studies, the inducible clindamycin ranged from 0% to 37.1% [ Table 4 ]. [ 7 12 15 16 17 18 19 20 21 22 23 24 25 26 27 ] It was observed that percentage of inducible clindamycin resistance was higher among MRSA (24.8%) compared to MSSA (7.5%). The difference between MSSA and MRSA isolates were not statistically significant ( P = 0.2340).…”

Section: Discussionmentioning

confidence: 99%

“…Constitutive clindamycin resistance in our study was observed in 7 (8.7%) of MSSA and 30 (23.3%) of MRSA isolates, which is similar to Chudasama et al . [ 17 ] The constitutive clindamycin resistance difference between MSSA and MRSA isolates were found to be statistically significant ( P = 0.0086). In different studies, the constitutive clindamycin resistance was reported varies from 1.77% to 52.3% [ Table 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…[ 15 ] In different studies, authors have reported the MS phenotype varies between 0.7% and 44.6% [ Table 4 ]. [ 7 12 15 16 17 18 19 20 21 22 23 24 25 26 27 ] This result implies that clindamycin can be safely and effectively instituted as a therapeutic option in this group of patients even in the presence of macrolide resistance.…”

Section: Discussionmentioning

confidence: 99%

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Detection of inducible and constitutive clindamycin resistance among Staphylococcus aureus isolates in a tertiary care hospital, Eastern India

et al. 2016

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Introduction:Clindamycin is an excellent drug for skin and soft tissue Staphylococcus aureus infections, but resistance mediated by inducible macrolide-lincosamide-streptogramin B (iMLSB) phenotype leads to in vivo therapeutic failure even though they may be in vitro susceptible in Kirby–Bauer disk diffusion method.Objective:The study was aimed to detect the prevalence of iMLSB phenotype among S. aureus isolates by double disk approximation test (D-test) in a tertiary care hospital, Eastern India.Materials and Methods:A total of 209 consecutive S. aureus isolates were identified by conventional methods and subjected to antimicrobial susceptibility testing by Kirby–Bauer disk diffusion method. Erythromycin-resistant isolates were tested for D-test.Results:From 1282 clinical specimens, 209 nonrepeated S. aureus isolates were obtained. Majority of isolates 129 (61.7%) were methicillin-resistant S. aureus (MRSA). There was statistically significant difference between outpatients 60.1% and inpatients 39.9% (P < 0.0001). From 209 S. aureus isolates, 46 (22%) were D-test positive (iMLSB phenotype), 41 (19.6%) were D-test negative (methicillin sensitive [MS] phenotype), and 37 (17.7%) were constitutively resistant (constitutive macrolide-lincosamide-streptogramin B phenotype). The incidence of inducible, constitutive, and MS phenotype was higher in MRSA isolates compared to MS S. aureus (MSSA). The constitutive clindamycin resistance difference between MSSA and MRSA isolates were found to be statistically significant (P = 0.0086).Conclusion:The study revealed 22% of S. aureus isolates were inducible clindamycin resistant, which could be easily misidentified as clindamycin susceptible in Kirby–Bauer disk diffusion method. Therefore, clinical microbiology laboratory should routinely perform D-test in all clinically isolated S. aureus to guide clinicians for the appropriate use of clindamycin.

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Prevalence of Constitutive and Inducible Clindamycin Resistance among Methicillin-Resistant Staphylococcus aureus Isolates in a Tertiary Care Hospital, Kashmir Valley

Akhter¹,

Nazir²,

Karnain³

et al. 2022

JoMMID

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Introduction:The increased frequency of Methicillin-resistant Staphylococcus aureus infections has led to renewed interest in the macrolide-lincosamide streptogramin B (MLS) group of antibiotics. Resistance to these antibiotics may be constitutive or inducible. Isolates resistant to erythromycin may show false in vitro susceptibility to clindamycin, leading to therapeutic failures. This study investigated the utility of the D-Test for detecting inducible clindamycin resistance in methicillin-resistant S. aureus isolates and determining the prevalence of various phenotypes in our region. Methods: For detecting inducible clindamycin resistance, a D-test using erythromycin and clindamycin as per CLSI guidelines was performed, and four different phenotypes were interpreted as methicillin-sensitive (MS) phenotype (D-test negative), inducible MLSB (iMLSB) phenotype (D-test positive), constitutive MLSB phenotype and sensitive to both. Results: Of the 987 isolates tested, 400 (40.53%) were MRSA. The prevalence of iMLSB, cMLSB phenotype, MS phenotype and sensitive phenotype in MRSA isolates was 42.5%, 10.5%, 28% and 19%, respectively. The iMLSB and cMLSB phenotypes were higher in males (24.75%, 6.25%) than females (P-value = 0.137). The majority of MRSA isolates originated from pus (83%). All S. aureus isolates showed 100% sensitivity to vancomycin and linezolid. Conclusion: This study emphasizes the prevalence of inducible clindamycin resistance in MRSA in our setup. Incorporating the D-test into the routine Kirby-Bauer disk diffusion method in clinical microbiology laboratories will help clinicians make judicious use of clindamycin, minimizing treatment failure.

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Prevalance of inducible clindamycin resistance of Staphylococcus aureus from various clinical specimens by D test in tertiary care hospital

Cited by 3 publications

References 6 publications

Inducible Clindamycin Resistance among Clinical Isolates of Staphylococcus aureus in a Tertiary Care Hospital, Nanded, Maharashtra, India

Inducible Clindamycin Resistance among Clinical Isolates of Staphylococcus aureus in a Tertiary Care Hospital, Nanded, Maharashtra, India

Detection of inducible and constitutive clindamycin resistance among Staphylococcus aureus isolates in a tertiary care hospital, Eastern India

Prevalence of Constitutive and Inducible Clindamycin Resistance among Methicillin-Resistant Staphylococcus aureus Isolates in a Tertiary Care Hospital, Kashmir Valley

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