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ORIGINAL ARTICLE
Year : 2012  |  Volume : 5  |  Issue : 5  |  Page : 468-470

Inducible clindamycin resistance in staphylococcus isolates from a tertiary care hospital in Eastern India


Department of Microbiology, R.G. Kar Medical College and Hospital, Kolkata, India

Correspondence Address:
Simit Kumar
Department of Microbiology, R.G. Kar Medical College and Hospital, Kolkata-700004
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.105134

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Purpose: The increasing resistance to antimicrobial agents among Staphylococci has led to renewed interest in the usage of macrolide-lincosamide-streptogramin B (MLS B ) antibiotics to treat Staphylococcus aureus (S. aureus) infections. The resistance to macrolide can be mediated by msr A gene coding for the efflux mechanism or via erm gene encoding for enzymes that confer inducible or constitutive resistance to MLS B antibiotics. In vitro routine tests for clindamycin susceptibility may fail to detect inducible clindamycin resistance due to erm genes resulting in treatment failure, thus necessitating the need to detect such resistance by a simple D test on a routine basis. Materials and Methods: One hundred and ninety-five S. aureus isolates were subjected to routine antibiotic susceptibility testing including cefoxitin (30 μg) by a modified Kirby Bauer disk diffusion method. Inducible resistance to clindamycin in S. aureus was tested by the "D test" as per CLSI guidelines. Results: Thirty-three (16.9%) isolates showed inducible clindamycin resistance, 45 (23%) showed a constitutive resistance while remaining 33 (16.9%) showed the MS phenotype. Inducible resistance and constitutive resistance were found to be higher in MRSA compared to MSSA (22.6%, 35.5%, and 11.8%, 11.8%, respectively). Conclusion: Clindamycin is kept as a reserve drug and is usually advocated in severe MRSA infections depending upon the antimicrobial susceptibility results. This study showed that a D test should be used as a mandatory method in routine disk diffusion testing to detect inducible clindamycin resistance in Staphylococci for the optimum treatment of patients.


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