International Journal of Contemporary Medicine

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

A Study of Inducible Clindamycin Resistance in Staphylococci in a Tertiary Care Hospital in Western Uttar Pradesh


Affiliations
1 Department of Microbiology, Saraswathi Institute of Medical Sciences, Hapur, (UP), India
     

   Subscribe/Renew Journal


Aim: The aim of this study was to determine inducible clindamycin resistance in erythromycinresistant, clindamycin-sensitive staphylococcal strains isolated from clinical specimens. Material and Method: A total of 108 erythromycin-resistant, clindamycin-sensitive staphylococcal isolates from various clinical specimens were tested using D-test according to CLSI guidelines. Result: A total of 23 (21.3%) staphylococcal isolates were found to be D-test positive and demonstrated inducible clindamycin resistance (iMLSB phenotype). MRSA isolates showed highest percentage (25.8%) of inducible clindamycin resistant phenotypes. Conclusion: Inducible clindamycin resistance should be checked in staphylococcal isolates before administering clindamycin therapy in staphylococcal infections as it can lead to clinical failure.

Keywords

D-test, MRSA, iMLSB Phenotype , Clindamycin, erm Methylase.
Subscription Login to verify subscription
User
Notifications
Font Size


  • K Prabhu,S Rao,V Rao. Inducible clindamycin resistance in staphylococcus aureus isolated from clinical samples. Journal of Laboratory Physicians, 2011; 3 (1): 25-27

  • Yilmaz G, Aydin K, Iskender S, Caylan R and Koksal I. Detection andprevalence of inducible clindamycin resistance in staphylococci. Journal of Medical Microbiology. 2007; 56: 342-345.

  • Deotale V, Mendiratta DK, Raut U, Narang P. Inducible clindamycin resistance in staphylococcus aureus isolated from clinical samples. Indian Journal of Medical Microbiology. 2010; 55 (2): 124-126

  • Fiebelkorn KR,Crawford SA, McElmeel ML, Jorgensen JH. Practical disc diffusion method for detection of inducible clindamycin resistance in staphylococcus aureus and coagulase- negative staphylococci. J Clin Microbiol. 2003; 41: 4740-4744.

  • Ciraj AM, Vinod P, Sreejith G et al. Inducible clindamycin resistance among clinical isolates of staphylococci. Indian J Pathol Microbiol. 2009; 52: 49-51.

  • Leclercq R. Mechanisms of resistance to macrolides and lincosamides. Clin Infect Dis. 2002; 34: 482–492.

  • Date K, Choudhary M, Thambare V. International Journal of Biological & Medical Research. 2012; 3 (3): 1922-1925.

  • Roberts MC, Sutcliffe J, Courvalin P, Jensen LB, Rood J, Seppala H. Nomenclature for macrolidelincosamide– streptogramin B resistance determinants. Antimicrob Agents Chemother. 1999; 43: 2823–2830.

  • Woods CR. The Pediatric Infectious Disease Journal. 2009; 28 (12): 1115-1118.

  • Catchpole I, Dyke KGH. A Staphylococcus aureus plasmid that specifies constitutive macrolide-licosamide-streptogramin B resistance contains a novel deletion in erm C attenuator. FEMS Microbiol Lett. 1990; 69: 43-48.

  • Werckenthin, C, Schwarz S , Westh, H. Structural alterations in the translational attenuator of constitutively expressed erm C genes . Antimicrob Agents Chemother.1999; 43: 1681– 1685.

  • Daurel C, Huet C, Dhalluin A, et al. Differences in potential for selection of clindamycin-resistant mutants between inducible erm(A) and erm(C) Staphylococcus aureus genes. J Clin Microbiol. 2008; 46: 546 –550.

  • Lewis JS II, Jorgensen JH. Inducible Clindamycin Resistance in Staphylococci: Should Clinicians and Microbiologists be Concerned? Clinical Infectious Diseases. 2005; 40: 280–285.

  • Jorgensen JH, Crawford SA, McElmeel ML, Fiebelkorn KR. Detection of inducible clindamycin resistance of staphylococci in conjunction with performance of automated broth susceptibility testing. J Clin Microbiol. 2004; 42: 1800–1802.

  • Watanakunakorn C. Clindamycin therapy of Staphylococcus aureus endocarditis: Clinical relapse and development of resistance to clindamycin, lincomycin and erythromycin. Am J Med. 1976; 60: 419-425.

  • Drinkovic D, Fuller ER, Shore KP, Holland DJ, Ellis-Pegler R. Clindamycin treatment of Staphylococcus aureus expressing inducible clindamycin resistance. J Antimicrob Chemother.2001; 48: 315-316.

  • Siberry GK, Tekle T, Carroll K, Dick J. Failure of clindamycin treatment of methicillin resistant Staphylococcus aureus expressing inducible clindamycin resistance in vitro. Clin Infect Dis 2003; 37: 1257-1260

  • Becker K, von Eiff C. Staphylococcus, micrococcus, and other catalase-positive cocci. Manual of clinical microbiology, tenth edition, Washington press, DC, ASM press. 2011; 1: 308- 330.

  • Clinical and laboratory standards institute (CLSI). Performance standards for antimicrobial susceptibility testing; twenty-second informational supplement. 2012; M100-S22, 32 (3).

  • Stevens DL, Ma Y, Salmi D, et al. Impact of antibiotics on expression of virulence-associated exotoxin genes. J Infect Dis. 2007; 195:202–211.


Abstract Views: 493

PDF Views: 0




  • A Study of Inducible Clindamycin Resistance in Staphylococci in a Tertiary Care Hospital in Western Uttar Pradesh

Abstract Views: 493  |  PDF Views: 0

Authors

Sanjeev Dimri
Department of Microbiology, Saraswathi Institute of Medical Sciences, Hapur, (UP), India
Shweta Rastogi
Department of Microbiology, Saraswathi Institute of Medical Sciences, Hapur, (UP), India
S. P. Garg
Department of Microbiology, Saraswathi Institute of Medical Sciences, Hapur, (UP), India

Abstract


Aim: The aim of this study was to determine inducible clindamycin resistance in erythromycinresistant, clindamycin-sensitive staphylococcal strains isolated from clinical specimens. Material and Method: A total of 108 erythromycin-resistant, clindamycin-sensitive staphylococcal isolates from various clinical specimens were tested using D-test according to CLSI guidelines. Result: A total of 23 (21.3%) staphylococcal isolates were found to be D-test positive and demonstrated inducible clindamycin resistance (iMLSB phenotype). MRSA isolates showed highest percentage (25.8%) of inducible clindamycin resistant phenotypes. Conclusion: Inducible clindamycin resistance should be checked in staphylococcal isolates before administering clindamycin therapy in staphylococcal infections as it can lead to clinical failure.

Keywords


D-test, MRSA, iMLSB Phenotype , Clindamycin, erm Methylase.

References