Detection of inducible clindamycin resistance by an automated system in a tertiary care hospital

Abstract

Clindamycin is commonly used in treatment of erythromycin resistant Staphylococcus aureus causing skin and soft tissue infections. 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 rapid method. In the era of automation, vitek-2 system provides a panel for detection of inducible clindamycin resistance with conjunction of other antimicrobial susceptibility testing. The present study evaluated the performance of a vitek-2 card for detection of inducible clindamycin resistance in a tertiary care hospital. Non-duplicate clinical isolates of hundred S. aureus were obtained from various clinical samples. Antimicrobial susceptibility testing was carried out, including detection of clindamycin resistance and methicillin resistance pattern by vitek-2 identification and antimicrobial susceptibility testing (ID/AST) system by using AST-GP67 card. The results were compared to those of D-test as per CLSI guidelines on erythromycin resistant isolates. EPI INFO software, Licensed by CDC Atlanta was used for analysis of data. The sensitivity and specificity for the vitek-2 card was 95.4 and 100%, respectively in comparism to disk approximation test (D-test),. The performance of vitek-2 card was 100% specific and rapid for detection of inducible clindamycin resistance with other antimicrobial susceptibility results.

Clindamycin Resistance among Staphylococcus Aureus Isolated at Mbarara Regional Referral Hospital, in South Western Uganda

“…Of these, 3% (9/300) isolates were constitutively resistant while 33% (99/300) were inducibly resistant (D-test positive). Similar studies have been conducted including one in India that reported a prevalence rate of 54% S. aureus resistance to CL of which 12% constitutively resistant and 43% Inducibly resistant [ 16 ]. Still in India Shantala et al 2011 reported prevalence rate of 43.15% S. aureus resistance to CL with 18.26% (42/230) constitutively resistant and 24.89 % (57/230) inducibly resistant [ 17 ].…”

Emergence of methicillin resistance and Panton‐Valentine leukocidin positivity in hospital‐ and community‐acquired Staphylococcus aureus infections in Beira, Mozambique

“…To avoid treatment failure, it is therefore necessary to detect such resistance by, for instance, a simple D ‐test on a routine basis (Jethwani et al . ; Prabhu et al . ).…”

Detection of inducible clindamycin resistance in Staphylococcus aureus from various samples in a tertiary care hospital

“…1,[28][29][30][31] The lowest prevalence was reported 3.5% by Kalpana D, Mamta C, Vilas T at Nagpur district and highest resistance was reported 90% by Dizbay M, Gunal O, Ozkan Y et al 32,33 However Deshmukh et al, reported 14.8% inducible clindamycin resistance. 19,[34][35][36] In this study, Overall prevalence of constitutive resistant isolates was 28%, Gurdal Yilmaz 17,18,29,31 Angel MR, Balaji V, Prakash J et al, didn't report any constitutive resistance in their study and Saderi H, Emadi B and Owlia P reported about 93% constitutive clindamycin resistance in their study. 34,37 In the present study, Chloramphenicol (74%) showed higher sensitivity pattern followed by Clindamycin (72%), where resistant isolates were higher in Penicillin-G (80%…”