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Background: Antibiotics called macrolide, lincosamide and streptogramin B (MLSB) are being used to treat staphylococci infections. Multiple pathways that impart resistance to MLSB antibiotics have been confirmed to cause clinical failure. The present work aimed to determine the frequency of constitutive and inducible clindamycin resistant among coagulase-negative staphylococci (CoNS) isolates of different clinical samples in Al-Basrah governorate, Iraq. Methods: The 28 CoNS, traditional techniques and the Vitek®2 system were used to identify the isolates. The disk diffusion technique was used to detect methicillin resistance and antibiotic sensitivity patterns via cefoxitin, gentamicin, ciprofloxacin, amikacin, teicoplanin, linezolid, doxycycline and vancomycin disks. Erythromycin and clindamycin antibiotic disks was used to detect the inducible and constitutive clindamycin resistance as well as a D-test according to CLSI guidelines. Results: Among 28 CoNS isolated, the Staphylococcus aureus 11(39.29%), Staphylococcus epidermidis 7(25 %), Staphylococcus haemolyticus 4(14.29%) and Staphylococcus saprophyticus 3 (10.71%) were predominant isolated species. Out of 28 CoNS isolates, 15(53.57%) were methicillin resistant coagulasenegative staphylococci (MRCoNS) isolates and 13(46.43%) were methicillin sensitive coagulase-negative staphylococci (MSCoNS) isolates. The 15(53.57%) isolates out of 28 CoNS, showed erythromycin resistance while 6(40%) isolates out of 15 CoNS, showed inducible macrolide-lincosamide-streptogramin B (iMLSB) and 2(13.3%) of CONS isolated showed constitutive macrolide-lincosamide-streptogramin B (cMLSB). Conclusions: In order to achive the best result in choosing the suitable treatment and avoiding the loses the money and time, it is better to use the D-test for inducible clindamycin resistance in the daily routine work of antibiotic susceptibility testing in hospital and private clinical laboratories.

This study aimed to determine total IgE in subjects under study and controls an estimation of the specific IgE antibody response against kiwifruit antigen by ELISA assay. There are many studies on against kiwifruit in other countries of the world, but this study differs in sample type and Geographical location. A total of one hundred twenty blood samples from allergic patients (41 Males and 55 female) with age group (15-69) years were tested by direct and indirect Enzyme-linked immunosorbent assay for total and specific IgE antibodies against kiwifruit antigens. In our result, we show that the total IgE 100>IU/ml for patients had a higher rate of (72.9%) with significant difference (p<0.01) between total IgE 100< IU/ml, the sera positivity against kiwifruit had a higher rate of (72.9 %) compared with control. Female and first age group ≥40 had a higher rate of sera positivity against allergens. At rate of (83.6%, 64.6%) respectively. Also, the rustles showed relationship between total (IgE<100IU/ml) and specific had higher rates in Sera negative kiwifruit allergens were (53.8%) compared with sera positivity against kiwi fruit allergens a rate of (27.1%) while the relationship between total (IgE>100 IU/ml) and specific IgE had higher rates in sera positivity against kiwifruit allergens at a rate of (78.6%) compared with sera negative kiwifruit allergens at a rate of (21.4%).

Microbiologists are increasingly concerned about the rise in S. aureus MLSB (macrolide, lincosamide, streptogramin B) drug resistance. Clindamycin has been effective in treating infections by S. aureus, and the variations in clindamycin sensitivity patterns cause treatment to fail. Inducible clindamycin resistance in S. aureus is expressed via erythromycin ribosome methylase genes. In the current study, 25 S. aureus isolates were identified by conventional chemical tests and the Vitek®2 system. Specific primers were used for the amplification of Macrolide genes by PCR. Among 25 S. aureus isolates, 23(92%) isolates were methicillin resistant and 2(8%) isolates were methicilin sensitive. The 5(20%) isolates showed resistance to Erythromycin and sensitivity to Clindamycin with a positive D test which was identified as inducible MLSB, while 2(8%) isolates showed resistance criteria for both Erythromycin and Clindamycin which identity as a constitutive MLSB and 18(92%) isolates were given the sensitivity for both Erythromycin and Clindamycin. The erm resistance genes (ermA, ermB,  ermC, ermF, and ermG) were detected in 5(20%), 17(68%), 25(100%), 24(96%),11(44%) respectively. The D-test, and Vitek ®2 system should be routinely done to avoid treatment failure due to clindamycin resistance.