Inducible Clindamycin Resistance Among Staphylococcal isolates at A Tertiary Care Centre, Gujarat
Authors/Creators
- 1. M.Sc. M.L.T Student, Smt. L.P. Patel Institute of Medical Laboratory Technology, BhaikakaUniversity, Karamsad, Gujarat
- 2. Assistant Professor, Microbiology Department, PS Medical college, Bhaikaka University, Karamsad, Gujarat
- 3. Professor, Microbiology Department, PS Medical college, Bhaikaka University, Karamsad, Gujarat
Description
Introduction: The increasing incidence of a variety of infections due to Staphylococcus aureus and other species of genus Staphylococcus, especially, its expanding role of community-associated methicillin -resistant S. aureus (MRSA)—has led to emphasis on the need for safe and effective agents to treat both systemic and localized staphylococcal infections. Clindamycin has been used successfully to treat variety of infections due to MRSA in adults and children. There is a mechanism of macrolide resistance in Staphylococcus spp. which also affects the lincosamide and type B streptogramin characterizing the so-called Macrolide-Lincosamide- type B Streptogramin (MLSB) resistance, whose expression can be constitutive (cMLSB) or inducible (iMLSB) and is encoded mainly by ermA and ermC genes. The cMLSB resistance is easily detected by susceptibility testing used in the laboratory routine, but iMLSB resistance is not. Simple laboratory testing (the erythromycin-clindamycin “D-zone” test) can separate strains that have the genetic potential (i.e., the presence of erm genes) to become resistant during therapy from strains that are fully susceptible to clindamycin. Aim: The study was planned to detect prevalence of iMLSB, cMLSB and MS phenotype resistance of clinical isolates of Staphylococcus aureus and Coagulase Negative Staphylococci (CONS) at tertiary care hospital, Gujarat. Material and Methods: This cross-sectional study was conducted on 105 isolates of Staphylococci from 1stMay 2021to 31st December 2021 at Microbiology section of Central Diagnostic Laboratory using Vitek 2 compact and manual disk diffusion method on Muller Hinton Agar. D test was performed on all the isolates of Staphylococci. Results: Out of 105 tested isolates, 19.05% were D test positive (iMLSB), 9.52% were constitutive phenotypes (cMLSB), 26.66% were D test negative (MS phenotype).The prevalence rate of both (iMLSB) and (cMLSB) was higher in Methicillin resistant isolates compared to Methicillin sensitive isolates. Conclusion: This study revealed recent magnitude of inducible clindamycin phenotype which could be easily missed while performing Kirby–Bauer disk diffusion method.So, it is recommended for clinical microbiology laboratory to routinely perform D‑test in all clinically isolated Staphylococci to prevent treatment failure.
Abstract (English)
Introduction: The increasing incidence of a variety of infections due to Staphylococcus aureus and other species of genus Staphylococcus, especially, its expanding role of community-associated methicillin -resistant S. aureus (MRSA)—has led to emphasis on the need for safe and effective agents to treat both systemic and localized staphylococcal infections. Clindamycin has been used successfully to treat variety of infections due to MRSA in adults and children. There is a mechanism of macrolide resistance in Staphylococcus spp. which also affects the lincosamide and type B streptogramin characterizing the so-called Macrolide-Lincosamide- type B Streptogramin (MLSB) resistance, whose expression can be constitutive (cMLSB) or inducible (iMLSB) and is encoded mainly by ermA and ermC genes. The cMLSB resistance is easily detected by susceptibility testing used in the laboratory routine, but iMLSB resistance is not. Simple laboratory testing (the erythromycin-clindamycin “D-zone” test) can separate strains that have the genetic potential (i.e., the presence of erm genes) to become resistant during therapy from strains that are fully susceptible to clindamycin. Aim: The study was planned to detect prevalence of iMLSB, cMLSB and MS phenotype resistance of clinical isolates of Staphylococcus aureus and Coagulase Negative Staphylococci (CONS) at tertiary care hospital, Gujarat. Material and Methods: This cross-sectional study was conducted on 105 isolates of Staphylococci from 1stMay 2021to 31st December 2021 at Microbiology section of Central Diagnostic Laboratory using Vitek 2 compact and manual disk diffusion method on Muller Hinton Agar. D test was performed on all the isolates of Staphylococci. Results: Out of 105 tested isolates, 19.05% were D test positive (iMLSB), 9.52% were constitutive phenotypes (cMLSB), 26.66% were D test negative (MS phenotype).The prevalence rate of both (iMLSB) and (cMLSB) was higher in Methicillin resistant isolates compared to Methicillin sensitive isolates. Conclusion: This study revealed recent magnitude of inducible clindamycin phenotype which could be easily missed while performing Kirby–Bauer disk diffusion method.So, it is recommended for clinical microbiology laboratory to routinely perform D‑test in all clinically isolated Staphylococci to prevent treatment failure.
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IJPCR,Vol15,Issue7,Article55.pdf
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Additional details
Dates
- Accepted
-
2023-07-10
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue7,Article55.pdf
- Development Status
- Active
References
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