Detection of inducible and constitutive clindamycin resistance among Staphylococcus aureus isolates in a tertiary care hospital, Eastern India

Introduction: Clindamycin is an excellent drug for skin and soft tissue Staphylococcus aureus infections, but resistance mediated by inducible macrolide-lincosamide-streptogramin B (iMLS B ) phenotype leads to in vivo therapeutic failure even though they may be in vitro susceptible in Kirby-Bauer di...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Subasini Majhi, Muktikesh Dash, Dharitri Mohapatra, Ashoka Mohapatra, Nirupama Chayani
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2016
Materias:	constitutive macrolide-lincosamide-streptogramin b phenotype d-test inducible macrolide-lincosamide-streptogramin b phenotype methicillin-resistant staphylococcus aureus sensitive methicillin phenotype methicillin-sensitive staphylococcus aureus staphylococcus aureus Medicine R
Acceso en línea:	https://doaj.org/article/97392d6ad17546f3b9c934215e4ea8c9
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:97392d6ad17546f3b9c934215e4ea8c9
record_format	dspace
spelling	oai:doaj.org-article:97392d6ad17546f3b9c934215e4ea8c92021-12-02T17:05:54ZDetection of inducible and constitutive clindamycin resistance among Staphylococcus aureus isolates in a tertiary care hospital, Eastern India2231-07702249-446410.4103/2231-0770.184066https://doaj.org/article/97392d6ad17546f3b9c934215e4ea8c92016-07-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.4103/2231-0770.184066https://doaj.org/toc/2231-0770https://doaj.org/toc/2249-4464Introduction: Clindamycin is an excellent drug for skin and soft tissue Staphylococcus aureus infections, but resistance mediated by inducible macrolide-lincosamide-streptogramin B (iMLS B ) phenotype leads to in vivo therapeutic failure even though they may be in vitro susceptible in Kirby-Bauer disk diffusion method. Objective: The study was aimed to detect the prevalence of iMLS B phenotype among S. aureus isolates by double disk approximation test (D-test) in a tertiary care hospital, Eastern India. Materials and Methods: A total of 209 consecutive S. aureus isolates were identified by conventional methods and subjected to antimicrobial susceptibility testing by Kirby-Bauer disk diffusion method. Erythromycin-resistant isolates were tested for D-test. Results: From 1282 clinical specimens, 209 nonrepeated S. aureus isolates were obtained. Majority of isolates 129 (61.7%) were methicillin-resistant S. aureus (MRSA). There was statistically significant difference between outpatients 60.1% and inpatients 39.9% (P < 0.0001). From 209 S. aureus isolates, 46 (22%) were D-test positive (iMLS B phenotype), 41 (19.6%) were D-test negative (methicillin sensitive [MS] phenotype), and 37 (17.7%) were constitutively resistant (constitutive macrolide-lincosamide-streptogramin B phenotype). The incidence of inducible, constitutive, and MS phenotype was higher in MRSA isolates compared to MS S. aureus (MSSA). The constitutive clindamycin resistance difference between MSSA and MRSA isolates were found to be statistically significant (P = 0.0086). Conclusion: The study revealed 22% of S. aureus isolates were inducible clindamycin resistant, which could be easily misidentified as clindamycin susceptible in Kirby-Bauer disk diffusion method. Therefore, clinical microbiology laboratory should routinely perform D-test in all clinically isolated S. aureus to guide clinicians for the appropriate use of clindamycin.Subasini MajhiMuktikesh DashDharitri MohapatraAshoka MohapatraNirupama ChayaniThieme Medical and Scientific Publishers Pvt. Ltd.articleconstitutive macrolide-lincosamide-streptogramin b phenotyped-testinducible macrolide-lincosamide-streptogramin b phenotypemethicillin-resistant staphylococcus aureussensitive methicillin phenotypemethicillin-sensitive staphylococcus aureusstaphylococcus aureusMedicineRENAvicenna Journal of Medicine, Vol 06, Iss 03, Pp 75-80 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	constitutive macrolide-lincosamide-streptogramin b phenotype d-test inducible macrolide-lincosamide-streptogramin b phenotype methicillin-resistant staphylococcus aureus sensitive methicillin phenotype methicillin-sensitive staphylococcus aureus staphylococcus aureus Medicine R
spellingShingle	constitutive macrolide-lincosamide-streptogramin b phenotype d-test inducible macrolide-lincosamide-streptogramin b phenotype methicillin-resistant staphylococcus aureus sensitive methicillin phenotype methicillin-sensitive staphylococcus aureus staphylococcus aureus Medicine R Subasini Majhi Muktikesh Dash Dharitri Mohapatra Ashoka Mohapatra Nirupama Chayani Detection of inducible and constitutive clindamycin resistance among Staphylococcus aureus isolates in a tertiary care hospital, Eastern India
description	Introduction: Clindamycin is an excellent drug for skin and soft tissue Staphylococcus aureus infections, but resistance mediated by inducible macrolide-lincosamide-streptogramin B (iMLS B ) phenotype leads to in vivo therapeutic failure even though they may be in vitro susceptible in Kirby-Bauer disk diffusion method. Objective: The study was aimed to detect the prevalence of iMLS B phenotype among S. aureus isolates by double disk approximation test (D-test) in a tertiary care hospital, Eastern India. Materials and Methods: A total of 209 consecutive S. aureus isolates were identified by conventional methods and subjected to antimicrobial susceptibility testing by Kirby-Bauer disk diffusion method. Erythromycin-resistant isolates were tested for D-test. Results: From 1282 clinical specimens, 209 nonrepeated S. aureus isolates were obtained. Majority of isolates 129 (61.7%) were methicillin-resistant S. aureus (MRSA). There was statistically significant difference between outpatients 60.1% and inpatients 39.9% (P < 0.0001). From 209 S. aureus isolates, 46 (22%) were D-test positive (iMLS B phenotype), 41 (19.6%) were D-test negative (methicillin sensitive [MS] phenotype), and 37 (17.7%) were constitutively resistant (constitutive macrolide-lincosamide-streptogramin B phenotype). The incidence of inducible, constitutive, and MS phenotype was higher in MRSA isolates compared to MS S. aureus (MSSA). The constitutive clindamycin resistance difference between MSSA and MRSA isolates were found to be statistically significant (P = 0.0086). Conclusion: The study revealed 22% of S. aureus isolates were inducible clindamycin resistant, which could be easily misidentified as clindamycin susceptible in Kirby-Bauer disk diffusion method. Therefore, clinical microbiology laboratory should routinely perform D-test in all clinically isolated S. aureus to guide clinicians for the appropriate use of clindamycin.
format	article
author	Subasini Majhi Muktikesh Dash Dharitri Mohapatra Ashoka Mohapatra Nirupama Chayani
author_facet	Subasini Majhi Muktikesh Dash Dharitri Mohapatra Ashoka Mohapatra Nirupama Chayani
author_sort	Subasini Majhi
title	Detection of inducible and constitutive clindamycin resistance among Staphylococcus aureus isolates in a tertiary care hospital, Eastern India
title_short	Detection of inducible and constitutive clindamycin resistance among Staphylococcus aureus isolates in a tertiary care hospital, Eastern India
title_full	Detection of inducible and constitutive clindamycin resistance among Staphylococcus aureus isolates in a tertiary care hospital, Eastern India
title_fullStr	Detection of inducible and constitutive clindamycin resistance among Staphylococcus aureus isolates in a tertiary care hospital, Eastern India
title_full_unstemmed	Detection of inducible and constitutive clindamycin resistance among Staphylococcus aureus isolates in a tertiary care hospital, Eastern India
title_sort	detection of inducible and constitutive clindamycin resistance among staphylococcus aureus isolates in a tertiary care hospital, eastern india
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2016
url	https://doaj.org/article/97392d6ad17546f3b9c934215e4ea8c9
work_keys_str_mv	AT subasinimajhi detectionofinducibleandconstitutiveclindamycinresistanceamongstaphylococcusaureusisolatesinatertiarycarehospitaleasternindia AT muktikeshdash detectionofinducibleandconstitutiveclindamycinresistanceamongstaphylococcusaureusisolatesinatertiarycarehospitaleasternindia AT dharitrimohapatra detectionofinducibleandconstitutiveclindamycinresistanceamongstaphylococcusaureusisolatesinatertiarycarehospitaleasternindia AT ashokamohapatra detectionofinducibleandconstitutiveclindamycinresistanceamongstaphylococcusaureusisolatesinatertiarycarehospitaleasternindia AT nirupamachayani detectionofinducibleandconstitutiveclindamycinresistanceamongstaphylococcusaureusisolatesinatertiarycarehospitaleasternindia
_version_	1718381803890278400

Detection of inducible and constitutive clindamycin resistance among Staphylococcus aureus isolates in a tertiary care hospital, Eastern India

Ejemplares similares