Journal of Laboratory Physicians
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ORIGINAL ARTICLE
Year : 2011  |  Volume : 3  |  Issue : 1  |  Page : 25-27

Inducible clindamycin resistance in Staphylococcus aureus isolated from clinical samples


Department of Microbiology, Yenepoya Medical College, Deralakatte, Mangalore, Karnataka, India

Correspondence Address:
Kavitha Prabhu
Department of Microbiology, Yenepoya Medical College, Deralakatte, Mangalore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2727.78558

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Introduction: The resistance to antimicrobial agents among Staphylococci is an increasing problem. This has led to renewed interest in the usage of Macrolide-Lincosamide-Streptogramin B (MLS B ) antibiotics to treat Staphylococcus aureus (S. aureus) infections. The resistance to macrolide can be mediated by msr A gene coding for efflux mechanism or via erm gene encoding for enzymes that confer inducible or constitutive resistance to MLS B antibiotics. In vitro routine tests for clindamycin susceptibility may fail to detect inducible clindamycin resistance due to erm genes resulting in treatment failure, thus necessitating the need to detect such resistance by a simple D test on a routine basis. Materials and Methods : One hundred and ninety S. aureus isolates were subjected to routine antibiotic susceptibility testing including oxacillin (1 ΅g) and cefoxitin (30 ΅g) by modified Kirby Bauer disc diffusion method. Inducible resistance to clindamycin in S. aureus was tested by 'D test' as per CLSI guidelines. Results: Twenty (10%) isolates showed inducible clindamycin resistance, 18 (9%) showed constitutive resistance while remaining 16 (8%) showed MS phenotype. Inducible resistance and constitutive resistance were found to be higher in MRSA as compared to MSSA (20%, 16% and 6%, 6%, respectively). Conclusion : Clindamycin is kept as a reserve drug and is usually advocated in severe MRSA infections depending upon the antimicrobial susceptibility results. This study showed that D test should be used as a mandatory method in routine disc diffusion testing to detect inducible clindamycin resistance in Staphylococci for the optimum treatment of patients.


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