Detection of Inducible Clindamycin Resistance of Staphylococci in Conjunction with Performance of Automated Broth Susceptibility Testing

Jorgensen, James H.; Crawford, S. A.; McElmeel, M. Leticia; Fiebelkorn, Kristin

doi:10.1128/jcm.42.4.1800-1802.2004

Cited by 76 publications

(54 citation statements)

References 9 publications

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“…6 (4) 33 (14) 9 (3) Wound swabs 32 (18) 4 (2) 24 (7) 5 (3) Skin swabs 21 (13) 4 (2) 17 (8) 4 (2) Nasal swabs 16 (7) 3 (2) 12 (4) 4 (2) Urine 9 (4) 3 (2) 5 (3) 3 (-) Body fluids…”

Section: Resultsunclassified

“…Erythromycin and clindamycin discs (HiMedia, Mumbai) were placed (17依2) mm apart (edge to edge) on a Muller-Hinton agar plate, incubated at 37 °C for 18 h and D-test positivity was identified by the flattening of clindamycin zone between erythromycin and clindamycin discs. Any isolate with "Er-r, Cd-r" was considered as constitutive MLSB resistant strain [14] .…”

Section: D-testmentioning

confidence: 99%

See 1 more Smart Citation

A report on infection dynamics of inducible clindamycin resistance of Staphylococcus aureus isolated from a teaching hospital in India

Dubey

Rath

Sahu

et al. 2013

Asian Pacific Journal of Tropical Biomedicine

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“…6 (4) 33 (14) 9 (3) Wound swabs 32 (18) 4 (2) 24 (7) 5 (3) Skin swabs 21 (13) 4 (2) 17 (8) 4 (2) Nasal swabs 16 (7) 3 (2) 12 (4) 4 (2) Urine 9 (4) 3 (2) 5 (3) 3 (-) Body fluids…”

Section: Resultsunclassified

Section: D-testmentioning

confidence: 99%

A report on infection dynamics of inducible clindamycin resistance of Staphylococcus aureus isolated from a teaching hospital in India

Dubey

Rath

Sahu

et al. 2013

Asian Pacific Journal of Tropical Biomedicine

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“…Macrolide resistance due to ribosomal target modification affects the activities of both macrolides and clindamycin; it is mediated by erythromycin ribosomal methylases encoded by ermA/ermC genes. Such resistance may be inducible or constitutive [8,9]. Macrolide resistance due to active efflux is encoded by the macrolide-streptogramin resistance (msrA) gene in Staphylococcus spp.…”

Section: Introductionmentioning

confidence: 99%

Inducible and constitutive clindamycin resistance in Staphylococcus aureus in a northeastern Indian tertiary care hospital

Banik

Khyriem

Gurung

et al. 2015

J Infect Dev Ctries

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Introduction: Staphylococcus aureus is one of the most common pyogenic bacteria. They are notorious for developing prompt resistance to newer antimicrobials. With increasing incidence of methicillin-resistant S. aureus (MRSA) isolates, the treatment options are also becoming limited. Clindamycin is an excellent drug for skin and soft tissue infections, but resistance mediated by the inducible phenotype (iMLS B ) leads to in vivo therapeutic failure even though there may be in vitro susceptibility. The double disk approximation test (D-test) can reliably detect the presence of such isolates. This study was aimed to detect and report the prevalence of the iMLS B phenotype in NEIGRIHMS, a tertiary care center in Northeast India. Methodology: A total of 243 consecutive isolates were subjected to routine identification tests followed by antimicrobial sensitivity testing.Erythromycin-resistant isolates were tested for inducible resistance phenotype by the D-test. Results: Among strains tested, 95 (39%) were erythromycin resistant. Twenty-six (10.7%) isolates were D-test positive (iMLS B phenotype), 41 (16.88%) were constitutively resistant (cMLS B phenotype), and 28 isolates (11.52%) were found to be negative by D-test. The incidence of both inducible and constitutive phenotypes was higher in MRSA isolates compared to methicillin-sensitive S. aureus (MSSA) isolates. Conclusions: This study revealed a moderate prevalence of the inducible clindamycin phenotype in the staphylococcal isolates tested. Clinical microbiology laboratories in areas of high MRSA prevalence should consider performing the D-test routinely. This will help prevent prescription of drug(s) whose therapeutic efficacy is doubtful.

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“…Although the CLSI method suggests placing the disks 15-20 mm apart for S. aureus and 20-26 mm apart for CoNS, 7 and there are studies highlighting the working of distances up to 28 mm in the literature; there are also studies suggesting the use of closer distances between 10-15 mm for obtaining more discriminating results in the D-zone test. 5,7,9,24,25 In our study, we did not perform the Dzone test with closer distances for every strain, but we believe that, at least for some of the isolates, the distance between the clindamycin and erythromycin disks were too far for observing the D shaped zone, and misled us for determining these probable iMLS B strains as MS B phenotypes. It is important to distinguish the iMLS B phenotype from the MS B phenotype, as the former ones may become resistant when lincosamides are used to treat the infection, thus they must be reported as lincosamide resistant.…”

Section: Mssa Mr-cons Ms-cons Totalmentioning

confidence: 99%

Distribution of erm and msr Genes Encoding Resistance to Macrolide, Lincosamide and Streptogramin B Antibiotics in Clinical Staphylococcus Isolates

Aksu¹,

Kuştımur²,

Karahan³

et al. 2012

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Cross-resistance is an important issue for macrolide, lincosamide and streptogramin B (MLS B ) antibiotics. The erm genes alter their ribosomal binding site by encoding ribosomal methylases. Phenotypic presentation of erm-mediated resistance can be inducible (iMLS B ) or constitutive (cMLS B ). Expression of msr genes which encode active efflux pumps confers the MS B phenotype. In this study, we investigated the frequency of MLS B resistance phenotypes and the presence of erm and msr genes in clinical Staphylococcus isolates. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : The frequency of MLS B resistance phenotypes were investigated using D-zone test in 731 clinical Staphylococcus strains. The presence of erm and msr genes was investigated by polymerase chain reaction in macrolide-resistant strains. R Re es su ul lt ts s: : Of the investigated isolates, 37.3% had iMLS B , 35.8% had cMLSB, and 26.9% had MS B phenotypes. Among studied, 45.9% of the strains carried ermC, 15.5% carried ermA, and 4.2% carried ermA and ermC genes. Phenotypic presentation of 51.4% of the erm gene carriers were iMLS B and 48.6% were cMLS B . Of the MS B phenotype strains, 73.3% carried the msrA+msrB gene combination and 3.3% carried msrB alone. Various erm and msr gene combinations were determined in 13.7% of the isolates of which 54.3% expressed iMLS B or cMLS B phenotypes and 45.7% expressed the MS B phenotype. MS B phenotype and gene combination frequencies were more in coagulase-negative staphylococci (CoNS). C Co on nc cl lu us si io on n: : I Investigating genes conferring resistance to lincosamides is important for reducing the risk of treatment failure especially for erythromycin resistant, clindamycin susceptible strains. Due to the increasing resistance problem in staphylococcal infections, clinicians must be aware of resistance development while prescribing MLS B antibiotics.K Ke ey y W Wo or rd ds s: : Staphylococcus; drug resistance, microbial; polymerase chain reaction Ö ÖZ ZE ET T A Am ma aç ç: : Makrolid-linkozamid-streptogramin B (MLS B ) grubu antibiyotikler için çapraz direnç önemli bir sorundur. erm genlerinin kodladığı ribozomal metilazlar, bu antibiyotiklerin hedefi olan ribozomları değiştirir. erm geni aracılı direncin fenotipik görünümü indüklenebilir (iMLS B ) veya yapısal (cMLS B ) olabilir. Aktif atım pompalarını kodlayan msr genlerinin ekspresyonu, MS B fenotipini ortaya çıkartır. Bu çalışmada, klinik Staphylococcus izolatında MLS B direnç fenotiplerinin sıklığı ve dirençli izolatlarda erm ve msr genlerinin araştırılması amaçlanmıştır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : MLS B direnç fenotiplerinin sıklığı 731 klinik Staphylococcus izolatında D-zon testi ile araştırılmış ve makrolid direnci bulunan suşlarda erm ve msr genleri polimeriz zincir reaksiyonu ile belirlenmiştir. B Bu ul lg gu ul la ar r: : Araştırılan izolatların %37,3'ünde iMLS B , %35,8'inde cMLS B , %26,9'unda ise MS B fenotipi gözlenmiştir. Suşların %45,9'un...

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Detection of Inducible Clindamycin Resistance of Staphylococci in Conjunction with Performance of Automated Broth Susceptibility Testing

Cited by 76 publications

References 9 publications

A report on infection dynamics of inducible clindamycin resistance of Staphylococcus aureus isolated from a teaching hospital in India

A report on infection dynamics of inducible clindamycin resistance of Staphylococcus aureus isolated from a teaching hospital in India

Inducible and constitutive clindamycin resistance in Staphylococcus aureus in a northeastern Indian tertiary care hospital

Distribution of erm and msr Genes Encoding Resistance to Macrolide, Lincosamide and Streptogramin B Antibiotics in Clinical Staphylococcus Isolates

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