Annals of Tropical Medicine and Public Health
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Year : 2012  |  Volume : 5  |  Issue : 5  |  Page : 427-430

Prevalence of inducible clindamycin resistance in clinical isolates of coagulase negative staphylococci at a tertiary care hospital

1 Department of Microbiology, Government Medical College Hospital, Sector-32, Chandigarh, India
2 Department of Microbiology, Pt. B.D.S. University of Health Sciences, Rohtak, Haryana, India
3 Department of General Medicine, National Institute of Medical Sciences, Jaipur, India

Correspondence Address:
Neha Bansal
Department of Microbiology, Government Medical College Hospital, Sector-32, Chandigarh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.105124

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Background : Coagulase negative staphylococci (CoNS) are an important group of multi-drug resistant nosocomial pathogens. Clindamycin resistance in staphylococci can be either constitutive or inducible. Clindamycin has been used successfully to treat pneumonia, soft-tissue and musculoskeletal infections due to methicillin-resistant CoNS (MRCoNS) in adults and children, but this matter is complicated by the possibility of inducible macrolide-lincosamide streptogramin B resistance (MLSBi). Aims: The present study was aimed to determine the incidence of inducible clindamycin resistance in CoNS isolates in our hospital using D-test, relationship between MRCoNS and MLSBi isolates, association of MLSBi isolates with community or nosocomial setting and treatment options for these isolates. Materials and Methods : A total of 250 consecutive, non-duplicate strains of CoNS were isolated from various clinical specimens, both from indoor and outdoor patients. After determining methicillin resistance, D-test was performed on all erythromycin-resistant and clindamycin-sensitive isolates to detect inducible clindamycin resistance. Results : Among 250 CoNS isolates, 89 (35.6%) were found to be MRCoNS and 20% had MLSBi phenotype. MRCoNS showed higher inducible as well as constitutive resistance (p<0.0001) to clindamycin as compared to methicillin-sensitive CoNS (MSCoNS). All isolates having MLSBi phenotype were sensitive to vancomycin and linezolid. Conclusions : Clindamycin is a useful drug in the treatment of staphylococcal infections. Hence, routine testing of staphylococcal isolates for inducible clindamycin resistance is strongly recommended.

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