ISSN : 0975-5276
EISSN : 0975-9174
N.B. DAFTARY1*, K.D. MEHTA2
1Department of Microbiology, Pandit Dindayal Upadhyay Medical College, Rajkot, 360001, Saurashtra University, Rajkot, 360005, Gujarat, India
2Department of Microbiology, Pandit Dindayal Upadhyay Medical College, Rajkot, 360001, Saurashtra University, Rajkot, 360005, Gujarat, India
* Corresponding Author : nirali.daftary10@gmail.com
Received : 16-04-2018 Accepted : 24-04-2018 Published : 30-04-2018
Volume : 10 Issue : 4 Pages : 1152 - 1154
Int J Microbiol Res 10.4 (2018):1152-1154
DOI : http://dx.doi.org/10.9735/0975-5276.10.4.1152-1154
Keywords : Clindamycin resistance, Constitutive MLSB, inducible MLSB, MS MLSB, MRSA
Conflict of Interest : None declared
Acknowledgements/Funding : Author thankful to Saurashtra University, Rajkot, 360005, Gujarat, India. Author also thankful to the Staff, Pandit Dindayal Upadhyay Medical College, Rajkot, 360001, for providing support for recruitment of patients and collection of samples.
Author Contribution : All author equally contributed
Background: Multidrug resistant Staphylococcus aureus is a problem worldwide. This has led to renewed interest in usage of Macrolide-Lincosamide-Streptogramin B (MLSB) antibiotics to treat Staphylococcal infections. The resistance to macrolide can be mediated by msr A gene coding for efflux mechanism or via erm genes. In vitro tests for clindamycin susceptibility may fail to detect inducible clindamycin resistance thus necessitating the need to detect such resistance by a simple D test on a routine basis. Methodology: 300 S. aureus isolates were subjected to routine antibiotic susceptibility testing including cefoxitin (30ug) by modified Kirby Bauer disc diffusion method. Erythromycin Inducible resistance to clindamycin in S. aureus was tested by “D test†as per CLSI guidelines. Results: Out of the 300 isolates; MS phenotype (MS Pheno) was seen in 10.3% (31) Erythromycin Inducible Clindamycin Resistance (iMLSb) is seen in 19% (58), constitutional (cMLSb) resistance was seen in 12% (36). Out of the total 58 Erythromycin Inducible Resistance Isolates, 63.79% (37) were associated with MRSA and 36.20% (21) were associated with MSSA. Conclusion: Clindamycin is kept as a reserve drug and is usually advocated in severe MRSA infections. This study showed that D test should be used mandatorily in routine disc diffusion test to detect inducible clindamycin resistance in S. aureus for optimum treatment of patients.
1. Yilmaz G., Aydin K., Iskender S., Caylan R., Koksal I. (2007) J Med Microbiol., 56, 342-345.
2. Delialioglu N., Aslan G., Ozturk C., Baki V., Sen S., Emekdas G. (2005) Jpn J Infect Dis., 58, 104-106.
3. Mendiratta D.K., Raut U., Narang P. (2010) Indian J Med Microbiol., 28, 124-126.
4. Ajantha G.S., Kulkarni R.D., Shetty J., Shubhada C., Jain P. (2008) Indian J Pathol Microbiol., 51, 376-378.
5. Lim H.S., Lee H., Roh K.H., Yum J.H., Yong D., Lee K., et al. (2006) Yonsei Med J., 47, 480-484.
6. Kavitha Prabhu, Sunil Rao, and Venkatakrishna Rao (2011) J Lab Physicians, 3(1), 25–27.
7. Clinical Laboratory Standards Institute.
8. Christine D. Steward, Patti M. Raney, Allison K. Morrell, Portia P. Williams, Linda K. McDougal, Laura Jevitt, John E. McGowan Jr. and Fred C. Tenover (2005) J. Clin. Microbiol., 43(4), 1716-1721.
9. Swati V Kant, Deepali Kulkarni, et al. (2015) Int.J. Curr. Microbiol.App.Sci., 4(2), 913-919.
10. Dubey D., Rath S., Sahu M.C., Rout S., Debata N.K., Padhy R.N. (2013) Asian Pac J Trop Biomed., 3(2), 148-153.
11. Deotale V., Mendiratta D.K., Raut U., Narang P. (2010) Indian J Med Microbiol., 28, 124-126.
12. Prabhu K., Rao S., Rao V. (2011) J Lab Physicians,3, 25-27.
13. Yoo Sang Baek, Jieyhun Jeon, Jae Woo Ahn, Hae Jun Song (2016) International Journal of Dermatology, 55(4), e191-e197.
14. Mokta K.K., Verma S., Chauhan D., Ganju S.A., Singh D., Kanga A., Kumari A., Mehta V. (2015) J Clin Diagn Res., 9(8), DC20-3.
15. Suvarna Vaibhav Sande (2015) Int J Adv Med., 2(3), 264-268.