Phenotypic and Genotypic Study of Inducible Clindamycin Resistance in Clinical Isolates of Staphylococcus aureus in Tabriz, Northwest Iran

Nikbakht, Mohsen; Rezaee, Mohammad Ahangarzadeh; Hasani, Alka; Nahaei, Mohammad Reza; Sadeghi, Javid; Seifi, Sirus Jedari

doi:10.5812/jjm.39274

Cited by 6 publications

(4 citation statements)

References 26 publications

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“…The prevalence of ermA/C was 13.1% ( n = 6) in our isolates. Nikbakht et al [34] showed the simultaneous presence of ermA and ermC in a significant number ( n = 39/215, 18.14%) of their isolates. Since strains with inducible resistance may mutate and alter to constitutive resistance, laboratories must correctly identify C susceptibility using the D-zone method for eliminating inducible C resistance.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Resistance to Macrolide–Lincosamide–Streptogramin B Among mecA-Positive Staphylococcus Aureus Isolates

Khodabandeh¹,

Mohammadi²,

Abdolsalehi³

et al. 2019

Osong Public Health Res Perspect

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Objectives Genetic determinants conferring resistance to macrolide, lincosamide, and streptogramin B (MLS B ) via ribosomal modification such as, erm , msrA/B and ereA/B genes are distributed in bacteria. The main goals of this work were to evaluate the dissemination of MLS B resistance phenotypes and genotypes in methicillin-resistant Staphylococcus aureus (MRSA) isolates collected from clinical samples. Methods A total of 106 MRSA isolates were studied. Isolates were recovered from 3 hospitals in Tehran between May 2016 to July 2017. The prevalence of MLS B -resistant strains were determined by D-test, and then M-PCR was performed to identify genes encoding resistance to macrolides, lincosamides, and streptogramins in the tested isolates. Results The frequency of constitutive resistance MLS B , inducible resistance MLS B and MS B resistance were 56.2%, 22.9%, and 16.6%, respectively. Of 11 isolates with the inducible resistance MLS B phenotype, ermC , ermB , ermA and ereA were positive in 81.8%, 63.6%, 54.5% and 18.2% of these isolates, respectively. In isolates with the constitutive resistance MLS B phenotype, the prevalence of ermA , ermB , ermC , msrA , msrB , ereA and ereB were 25.9%, 18.5%, 44.4%, 0.0%, 0.0%, 11.1% and 0.0%, respectively. Conclusion Clindamycin is commonly administered in severe MRSA infections depending upon the antimicrobial susceptibility findings. This study showed that the D-test should be used as an obligatory method in routine disk diffusion assay to detect inducible clindamycin resistance in MRSA so that effective antibiotic treatment can be provided.

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Section: Discussionmentioning

confidence: 99%

Analysis of Resistance to Macrolide–Lincosamide–Streptogramin B Among mecA-Positive Staphylococcus Aureus Isolates

Khodabandeh¹,

Mohammadi²,

Abdolsalehi³

et al. 2019

Osong Public Health Res Perspect

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“…A similar study in the Kashmir region showed that MRSA isolates were 100% resistant to penicillin, followed by erythromycin (78%) [11]. Also, studies from various parts of India [20,25,46,49] indicated similar antibiotic sensitivity patterns. Here, we detected 100% susceptibility to vancomycin; a similar study from the Kashmir region [50] found that S. aureus isolates were 100% susceptible to linezolid and vancomycin, followed by ciprofloxacin (60.43%).…”

Section: Discussionmentioning

confidence: 80%

Prevalence of Constitutive and Inducible Clindamycin Resistance among Methicillin-Resistant Staphylococcus aureus Isolates in a Tertiary Care Hospital, Kashmir Valley

Akhter¹,

Nazir²,

Karnain³

et al. 2022

JoMMID

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Introduction:The increased frequency of Methicillin-resistant Staphylococcus aureus infections has led to renewed interest in the macrolide-lincosamide streptogramin B (MLS) group of antibiotics. Resistance to these antibiotics may be constitutive or inducible. Isolates resistant to erythromycin may show false in vitro susceptibility to clindamycin, leading to therapeutic failures. This study investigated the utility of the D-Test for detecting inducible clindamycin resistance in methicillin-resistant S. aureus isolates and determining the prevalence of various phenotypes in our region. Methods: For detecting inducible clindamycin resistance, a D-test using erythromycin and clindamycin as per CLSI guidelines was performed, and four different phenotypes were interpreted as methicillin-sensitive (MS) phenotype (D-test negative), inducible MLSB (iMLSB) phenotype (D-test positive), constitutive MLSB phenotype and sensitive to both. Results: Of the 987 isolates tested, 400 (40.53%) were MRSA. The prevalence of iMLSB, cMLSB phenotype, MS phenotype and sensitive phenotype in MRSA isolates was 42.5%, 10.5%, 28% and 19%, respectively. The iMLSB and cMLSB phenotypes were higher in males (24.75%, 6.25%) than females (P-value = 0.137). The majority of MRSA isolates originated from pus (83%). All S. aureus isolates showed 100% sensitivity to vancomycin and linezolid. Conclusion: This study emphasizes the prevalence of inducible clindamycin resistance in MRSA in our setup. Incorporating the D-test into the routine Kirby-Bauer disk diffusion method in clinical microbiology laboratories will help clinicians make judicious use of clindamycin, minimizing treatment failure.

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“…32 The results of the antimicrobial susceptibility test by routine disk diffusion method showed that the highest antimicrobial resistance rate was against erythromycin 83.3% of S. aureus and clindamycin 53.3% of isolates, these results are close to those reported by previous studies. 29,33 In S. epidermidis, the resistance rates for erythromycin and clindamycin were 73.3 and 45%, respectively. These outcomes were lower than those reported by another study.…”

Section: Discussionmentioning

confidence: 99%

“…This result is lower than that reported in another study that showed a high rate of MRSA 93%. 34 Additionally, VRSA showed in 19 isolates (31.7%) of S. aureus 33 and among S. epidermidis isolates, 11.7% of isolates showed vancomycin resistance. This result is close from that reported by another local study that recorded a vancomycin resistance rate 10%, 32 but this result is far from this obtained by another local study that reported a resistance rate 40%.…”

Section: Discussionmentioning

confidence: 99%

Phenotypic Detection of Macrolide-Lincosamide-Streptogramin Resistance among Staphylococcus aureus and Staphylococcus epidermidis in Baghdad, Iraq

Al-Salmani

Al-Qaisi

2020

ijddt

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Introduction: Staphylococci emerged as the most frequent nosocomial and community-acquired pathogens. Macrolide-lincosamide-streptogramin (MLS) antibiotics resistance was increasing among Staphylococcus aureus and Staphylococcus epidermidis (S. epidermidis) isolates. Objective: In the present study, the aim was to detect the phenotypic resistance pattern of MLS (constitutive and inducible) among S. aureus and S. epidermidis isolated from Iraqi patients. Methods: A total of 120 staphylococcal isolates (60 S. aureus and 60 S. epidermidis) were isolated from urine, wound swab, blood, and sputum specimens, then specified by the VITEK 2 system. Whole isolates were investigated by the disk-diffusion method against many antibiotics, then they were checked for the MLS phenotype by the D-zone test. Results: Out of 60 S. aureus isolates and 60 S. epidermidis, the isolation rates from wound, urine, blood, and sputum were 66.6 and 50%, 16.7 and 26.7%, 11.7 and 18.3%, and 5% for each species, respectively. The higher frequency rates of resistance were showed against erythromycin, clindamycin, and streptomycin, for both S. aureus with 83.3, 53.3, and 83.3%, respectively, and S. epidermidis with 73.3, 45, and 76.7%, respectively. Constitutive MLS resistance phenotype (MLSc) was shown in 32 isolates (53.3%) of S. aureus and inducible MLS resistance phenotype (MLSi) was noted in 16 isolates (26.7%). Conclusion: The current study concluded that the D-zone test must be applied within the routine work of the antimicrobial susceptibility test for staphylococcal isolates, to exclude the false results of staphylococcal isolates sensitivity against clindamycin.

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Phenotypic and Genotypic Study of Inducible Clindamycin Resistance in Clinical Isolates of Staphylococcus aureus in Tabriz, Northwest Iran

Cited by 6 publications

References 26 publications

Analysis of Resistance to Macrolide–Lincosamide–Streptogramin B Among mecA-Positive Staphylococcus Aureus Isolates

Analysis of Resistance to Macrolide–Lincosamide–Streptogramin B Among mecA-Positive Staphylococcus Aureus Isolates

Prevalence of Constitutive and Inducible Clindamycin Resistance among Methicillin-Resistant Staphylococcus aureus Isolates in a Tertiary Care Hospital, Kashmir Valley

Phenotypic Detection of Macrolide-Lincosamide-Streptogramin Resistance among Staphylococcus aureus and Staphylococcus epidermidis in Baghdad, Iraq

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