Detection and Prevalence of Inducible Clindamycin Resistance in Clinical Isolates of Staphylococcus aureus: Experience from Tertiary Care Hospital in Jaipur
Keywords:Clindamycin, D-test, Methicillin-resistant Staphylococcus aureus, Staphylococcus, Susceptibility
Background: Staphylococcus aureus is a frequent cause of bacterial infections in both developed and developing countries. Emerging resistance to methicillin in this organism has left us with very few therapeutic alternatives to treat the infections caused by them. Objective: We aimed to determine the prevalence of inducible clindamycin resistance in clinical isolates of S. aureus and antimicrobial susceptibility pattern of S. aureus isolates due to the increasing prevalence of resistance to most antimicrobial agents in staphylococci signifies the need for new effective agents to treat staphylococcal infections. Methods: The study was carried out in the Department of Microbiology at Mahatma Gandhi Hospital, Sitapura, Jaipur, Rajasthan. All S. aureus isolates (non-repetitive) from different clinical samples received in clinical microbiology laboratory from in and outpatients in Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, were included in the study. Results: Out of 157 erythromycin-resistant S. aureus, 74 (47.133%) show MS phenotype, 48 (30.57%) show inducible clindamycin resistance, and 35 (22.29%) show constitutive resistance. All 48 S. aureus isolates which showed inducible clindamycin resistances (D-test positive) were further subjected to antimicrobial susceptibility testing.In the present study, 100% sensitivity was observed by vancomycin, linezolid and tigecycline, followed by tetracycline, 89.58% and gentamicin, 83.33% while 100% resistivity were observed by levofloxacin. Conclusion: We can conclude that there is high percentage of inducible clindamycin resistance among Staphylococcus isolates. If D-test would not have been performed, many inducible clindamycin-resistant S. aureus could have been easily misidentified as clindamycin susceptible, leading to therapeutic failure. Thus, simple and reliable D-test can be incorporated into routine in clinical microbiology laboratory.
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Copyright (c) 2022 Aishwarya Shrigaur, Ved Prakash Mamoria, Ekadashi Rajni, Richa Sharma
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