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Inducible Clindamycin resistance in Staphylococcus aureus in a tertiary care Rural Hospital

Journal Name:

  • Indian Journal of Basic & Applied Medical Research

Publication Year:

  • 2013

Key Words:

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Abstract (2. Language): 
Introduction: Macrolide (MLSB) resistance is the most widespread and clinically important mechanism of resistance encountered with Gram-positive organisms. Resistance may be constitutive (cMLSB phenotype) or inducible (iMLSB phenotype). The iMLSB phenotypes are not differentiated by using standard susceptibility test methods, but can be distinguished by erythromycin-clindamycin disk approximation test (D-test) and demonstration of resistance genes by molecular methods. The present study was planned to demonstrate in vitro inducible clindamycin resistance (iMLSB) in erythromycin-resistant (ER) clinical isolates of S.aureusto guide therapy. And to find out the relationship of MRSA with inducible clindamycin resistance Materials and Methods: 256 Staphylococcusaureus isolates were examined for inducible clindamycin resistance by using D-test at 15 mm disk separation as per CLSI guidelines on erythromycin resistant isolates. Results: 142(55.46%) clinical isolates showed erythromycin resistance.76(53.52%) isolates were found to exhibit the constitutive resistance,30(21.12%) the inducible MLSB resistance phenotype and non-inducible(MS) in 36(25.35%). Two distinct induction phenotypes (18.30%) and D + (2.81%) were observed. In MRSA isolates, 39.43% had the constitutive, 13.38% had the iMLSB resistance and 16.19% had MS phenotype. In MSSA, 14.08% and 7.7% isolates were found to have the constitutive and inducible MLSB resistance phenotypes respectively while 9.15% exhibited the MS phenotype. Thus, both the constitutive and inducible resistance phenotypes werefound to be significantly higher in MRSA isolates as compared to MSSA (39.43%, 13.38 % and 14.08% and 7.7% and constitutive MLSB was predominant(53.52%) Conclusion: Study showed that D test should be used as a mandatory method in routine disc diffusion testing to detect inducible clindamycin resistance.
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