Phenotypic detection of inducible clindamycin resistance among  Staphylococcus aureus  isolates by using the lower limit of recommended inter-disk distance

Ajantha, GS; Kulkarni, Raghavendra; Shetty, Jeevan; Shubhada, C; Jain, Pavithra Amrath

doi:10.4103/0377-4929.42515

Cited by 52 publications

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“…Empirical outpatient treatment options for staphylococcal infections have become more limited as concerns about the prevalence of MRSA have increased [1,14]. Among the options available for MRSA and MSSA infections, clindamycin has evoked much interest.…”

Section: Discussionmentioning

confidence: 99%

“…It is known for acquiring antimicrobial resistance promptly after introduction of new antibiotics [1]. Emergence of methicillin resistance in S. aureus has left very few therapeutic alternatives.…”

Section: Introductionmentioning

confidence: 99%

“…It has excellent tissue penetration except into the central nervous system, where it does not cross the blood-brain barrier, even in the presence of inflamed meninges [3]. Good oral absorption makes it an attractive option for outpatient prescription or as a follow-up drug after intravenous therapy [1,4]. This permits an early transition to outpatient management of the susceptible infection without the complication of continued intravenous access [5].…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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“…This was in concordance with few of the studies reported before (1,13) . Some studies have shown a very high frequency of inducible resistance MRSA (24) . On the contrary, few studies have shown a higher percentage of inducible resistance in MSSA as compared to MRSA 96,25) .…”

Section: Discussionmentioning

confidence: 99%

Inducible Clindamycin Resistance in Clinical Isolates of Staphylococci

Zaher¹

2017

IAM

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Background: The increasing frequency of methicillin-resistant Staphylococcus aureus (MRSA) infections and the changing patterns of antimicrobial resistance have led to renewed interest in the use of macrolide-lincosamidestreptogramin B (MLSB) antibiotics to treat such infections. However, resistance to MLSB antibiotics has been reported to be mediated by the msrA gene coding for efflux mechanism and erm gene which encoding the enzymes conferring resistance to MLSB antibiotics. Routine antibiotic sensitivity tests for clindamycin may fail to detect inducible clindamycin resistance due to the presence of the erm gene thereby resulting in failure of treatment. Aim: This study was undertaken to detect the presence of inducible clindamycin resistance among clinical isolates of staphylococci. Materials and Methods: A total of 247 strains of staphylococci (S. aureus -158 and coagulasenegative staphylococci (CoNS) -89), isolated from various clinical samples were included in this study. The isolates were identified using conventional methods. Inducible clindamycin resistance was tested by D test as per the CLSI guidelines. Results: Of total 247 isolates included in this study 52(21.05%) were MRSA, 67(27.13%) were Methicillin Resistant Coagulase Negative Staphylococci (MR-CoNS). Inducible clindamycin resistance was detected in 13.46 % of 52 MRSA and 2.99% of 67 MR-CoNS. Conclusion: Staphylococcal isolates, particularly MRSA, must be tested routinely by the D-test before treatment so that the clindamycin drug is used effectively and for maximum clinical utility.

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“…One of such effective alternative is macrolide- With excellent pharmacokinetic properties, Clindamycin has taken over as the most ideal antibiotic. (Delialioglu et al, 2005) However, extensive use of MLS B antibiotics has led the strains to acquire resistance to these antibiotics (Deotale et al, 2010;Ajantha et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Detection of Inducible Clindamycin Resistance with Erythromycin in Clinical Isolates and Its Prevalence among Methicillin Resistant Staphylococcus aureus

Lakshmi¹,

Saikumar²

2018

Int.J.Curr.Microbiol.App.Sci

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Phenotypic detection of inducible clindamycin resistance among Staphylococcus aureus isolates by using the lower limit of recommended inter-disk distance

Cited by 52 publications

References 0 publications

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

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

Inducible Clindamycin Resistance in Clinical Isolates of Staphylococci

Detection of Inducible Clindamycin Resistance with Erythromycin in Clinical Isolates and Its Prevalence among Methicillin Resistant Staphylococcus aureus

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