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A Study of Inducible Clindamycin Resistance among Staphylococcus aureus Skin and Soft Tissue Infections in A Tertiary Care Hospital

Year 2019, , 125 - 128, 15.09.2019
https://doi.org/10.5799/jmid.614241

Abstract

ABSTRACT



Objectives: Drug resistant phenotypes like MRSA are difficult to
treat requiring higher group of antibiotics. Topical agents like clindamycin
can be used for the therapy of MRSA. The knowledge of prevalence of inducible
clindamycin resistance phenotype is essential to prevent treatment failure.



Methods:
A total of 204 staphylococcal isolates obtained from skin and soft tissue
infections and MRSA was detected by Cefoxitin disc diffusion method and
detection of Mec A gene by Polymerase
chain reaction (PCR). Antibiotic susceptibility testing was performed by Kirby Baeur
disc diffusion method. The Erythromycin resistant isolates were tested for D
test. The differences in antibiotic susceptibility pattern between MRSA and
MSSA was compared by Chi Square test using Graph pad Quick Calcs software and p
value less than 0.05 was considered as significant



Results:
Out of the 204 Staphylococcus aureus isolates, 48 (23.5%) were identified as
MRSA by Cefoxitin disc diffusion method. All these 48(23.5%) of isolates were
also positive for Mec A gene by PCR.
Inducible clindamycin resistance (iMLSB resistance phenotype) was observed
among 24(11.7%) of the isolates. MRSA showed comparatively lesser
susceptibility than MSSA (p ≤0.05). Among the MRSA inducible clindamycin
resistance was seen among 11 (22.9%).



Conclusions: Emergence of drug resistance warrants antibiotic
susceptibility testing for all the isolates in the laboratory. Cefoxitin disc
diffusion method can be used in resource constraint laboratory where PCR
facilities are not available. Inducible clindamycin resistance phenotype (iMLS
phenotype) must be checked for all isolates showing erythromycin resistance to
prevent treatment failure.
J Microbiol
Infect Dis 2019; 9(3):125-128.

References

  • 1. Arora S, Devi P, Arora U, Devi B. Prevalence of Methicillin- resistant Staphylococcus aureus (MRSA) in a tertiary care hospital in northern India. J Lab Physicians 2010; 2(2):78-81. 2. Ajantha GS, Kulkarni RD, Shetty J, Shubhada C, Jain P. Phenotypic detection of inducible clindamycin resistance among Staphylococcus aureus isolates by using the lower limit of recommended inter-disk distance. Indian J Pathol Microbiol 2008; 51(3)376-378. 3. Levin TP, Suh B, Axelrod P, Truant AL, Fekete T. Potential clindamycin resistance in clindamycin-susceptible, erythromycin-resistant Staphylococcus aureus: Report of a clinical failure. Antimicrob Agents Chemother 2005; 49:1222-1224 (13). 4. Clinical and laboratory standards institute. Performance standards for antimicrobial susceptibility testing.Clinical Laboratory Standards Institute.Wayne, PA, USA, M100S, 26th edition 2016; 36:74-81. 5. Deotale V, Mendiratta DK, Raut U, Narang P. Inducible clindamycin resistance in Staphylococcus aureus isolated from clinical samples. Indian J Med Microbiol 2010; 28:124-126. 6. Anand KB, Agrawal P, Kumar S, Kapila K. Comparison of the Cefoxitin disc diffusion test, the oxacillin screen agar test and PCR for the Mec A gene for detection of MRSA. Indian J Med Microbiol 2009; 27: 27-29. 7. Prabhu K, Rao S, Rao V. Inducible clindamycin resistance in Staphylococcus aureus isolated from clinical samples. J Lab Physicians 2011; 3:25-27. 8. Phukan C, Ahmed GU, Sarma PP. Inducible clindamycin resistance among staphylococcus aureus isolates in a tertiary care hospital of Assam. Indian J Med Microbiol 2015; 33:456-458. 9. Vidhani S,Mehndiratta P, Mathur M. Study of methicillin resistant S.aurus (MRSA) isolates from high risk patients.Indian J Med Microbiol 2001;19:13-16. 10. Menezes GA, Harish BN, Sujatha S, Vinothini K, Parija SC. Emergence of vancomycin-intermediate Staphylococcus species in southern India. J Med Microbiol 2008; 57:911-912. 11. Majumder D, Bordoloi JS, Phukan AC, Mahanta J. Antimicrobial susceptibility pattern among methicillin resistant staphylococcus isolates in Assam. Indian J Med Microbiol 2001; 19:138-140. 12. Indian Network for Surveillance of Antimicrobial Resistance INSAR) Group, India. Methicillin resistant Staphylococcus aureus (MRSA) in India: Prevalence and susceptibility pattern. Indian J Med Res 2013; 137:363-369. 13. Tiwari HK, Das AK, Sapkota D, Sivarajan K, Pahwa VK. Methicillin resistant Staphylococcus aureus: Prevalence and antibiogram in a tertiary care hospital in western Nepal. J Infect Dev Ctries 2003; 3:681-684. 14. Rajaduraipandi K, Mani KR, Panneerselvam K, Mani M, Bhaskar M, Manikandan M. Prevalence and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus: A multicentre study.Indian J Med Microbiol 2006; 24:34-38. 15. Aleksandra AD, Misic MS, Mira ZV, et al. Prevalence of inducible clindamycin resistance among community associated staphylococcal isolates in central Serbia. Indian J Med Microbiol 2014; 32:49-52. 16. Shenoy MS, Bhat GK, Kishore A, Hassan MK. Significance of MRSA strains in community associated skin and soft tissue infections. Indian J Med Microbiol 2010; 28:152–154.
Year 2019, , 125 - 128, 15.09.2019
https://doi.org/10.5799/jmid.614241

Abstract

References

  • 1. Arora S, Devi P, Arora U, Devi B. Prevalence of Methicillin- resistant Staphylococcus aureus (MRSA) in a tertiary care hospital in northern India. J Lab Physicians 2010; 2(2):78-81. 2. Ajantha GS, Kulkarni RD, Shetty J, Shubhada C, Jain P. Phenotypic detection of inducible clindamycin resistance among Staphylococcus aureus isolates by using the lower limit of recommended inter-disk distance. Indian J Pathol Microbiol 2008; 51(3)376-378. 3. Levin TP, Suh B, Axelrod P, Truant AL, Fekete T. Potential clindamycin resistance in clindamycin-susceptible, erythromycin-resistant Staphylococcus aureus: Report of a clinical failure. Antimicrob Agents Chemother 2005; 49:1222-1224 (13). 4. Clinical and laboratory standards institute. Performance standards for antimicrobial susceptibility testing.Clinical Laboratory Standards Institute.Wayne, PA, USA, M100S, 26th edition 2016; 36:74-81. 5. Deotale V, Mendiratta DK, Raut U, Narang P. Inducible clindamycin resistance in Staphylococcus aureus isolated from clinical samples. Indian J Med Microbiol 2010; 28:124-126. 6. Anand KB, Agrawal P, Kumar S, Kapila K. Comparison of the Cefoxitin disc diffusion test, the oxacillin screen agar test and PCR for the Mec A gene for detection of MRSA. Indian J Med Microbiol 2009; 27: 27-29. 7. Prabhu K, Rao S, Rao V. Inducible clindamycin resistance in Staphylococcus aureus isolated from clinical samples. J Lab Physicians 2011; 3:25-27. 8. Phukan C, Ahmed GU, Sarma PP. Inducible clindamycin resistance among staphylococcus aureus isolates in a tertiary care hospital of Assam. Indian J Med Microbiol 2015; 33:456-458. 9. Vidhani S,Mehndiratta P, Mathur M. Study of methicillin resistant S.aurus (MRSA) isolates from high risk patients.Indian J Med Microbiol 2001;19:13-16. 10. Menezes GA, Harish BN, Sujatha S, Vinothini K, Parija SC. Emergence of vancomycin-intermediate Staphylococcus species in southern India. J Med Microbiol 2008; 57:911-912. 11. Majumder D, Bordoloi JS, Phukan AC, Mahanta J. Antimicrobial susceptibility pattern among methicillin resistant staphylococcus isolates in Assam. Indian J Med Microbiol 2001; 19:138-140. 12. Indian Network for Surveillance of Antimicrobial Resistance INSAR) Group, India. Methicillin resistant Staphylococcus aureus (MRSA) in India: Prevalence and susceptibility pattern. Indian J Med Res 2013; 137:363-369. 13. Tiwari HK, Das AK, Sapkota D, Sivarajan K, Pahwa VK. Methicillin resistant Staphylococcus aureus: Prevalence and antibiogram in a tertiary care hospital in western Nepal. J Infect Dev Ctries 2003; 3:681-684. 14. Rajaduraipandi K, Mani KR, Panneerselvam K, Mani M, Bhaskar M, Manikandan M. Prevalence and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus: A multicentre study.Indian J Med Microbiol 2006; 24:34-38. 15. Aleksandra AD, Misic MS, Mira ZV, et al. Prevalence of inducible clindamycin resistance among community associated staphylococcal isolates in central Serbia. Indian J Med Microbiol 2014; 32:49-52. 16. Shenoy MS, Bhat GK, Kishore A, Hassan MK. Significance of MRSA strains in community associated skin and soft tissue infections. Indian J Med Microbiol 2010; 28:152–154.
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Details

Primary Language English
Journal Section Research Article
Authors

Abirami Lakshmy Jayachandiran This is me

Balan Kandasamy This is me

Sangeetha Vilwanatha This is me

Sheila Doris Devami T. This is me

Vanitha Devi E. This is me

Vandhitha Muralidharan This is me

Publication Date September 15, 2019
Published in Issue Year 2019

Cite

APA Jayachandiran, A. L., Kandasamy, B., Vilwanatha, S., T., S. D. D., et al. (2019). A Study of Inducible Clindamycin Resistance among Staphylococcus aureus Skin and Soft Tissue Infections in A Tertiary Care Hospital. Journal of Microbiology and Infectious Diseases, 09(03), 125-128. https://doi.org/10.5799/jmid.614241
AMA Jayachandiran AL, Kandasamy B, Vilwanatha S, T. SDD, E. VD, Muralidharan V. A Study of Inducible Clindamycin Resistance among Staphylococcus aureus Skin and Soft Tissue Infections in A Tertiary Care Hospital. J Microbil Infect Dis. September 2019;09(03):125-128. doi:10.5799/jmid.614241
Chicago Jayachandiran, Abirami Lakshmy, Balan Kandasamy, Sangeetha Vilwanatha, Sheila Doris Devami T., Vanitha Devi E., and Vandhitha Muralidharan. “A Study of Inducible Clindamycin Resistance Among Staphylococcus Aureus Skin and Soft Tissue Infections in A Tertiary Care Hospital”. Journal of Microbiology and Infectious Diseases 09, no. 03 (September 2019): 125-28. https://doi.org/10.5799/jmid.614241.
EndNote Jayachandiran AL, Kandasamy B, Vilwanatha S, T. SDD, E. VD, Muralidharan V (September 1, 2019) A Study of Inducible Clindamycin Resistance among Staphylococcus aureus Skin and Soft Tissue Infections in A Tertiary Care Hospital. Journal of Microbiology and Infectious Diseases 09 03 125–128.
IEEE A. L. Jayachandiran, B. Kandasamy, S. Vilwanatha, S. D. D. T., V. D. E., and V. Muralidharan, “A Study of Inducible Clindamycin Resistance among Staphylococcus aureus Skin and Soft Tissue Infections in A Tertiary Care Hospital”, J Microbil Infect Dis, vol. 09, no. 03, pp. 125–128, 2019, doi: 10.5799/jmid.614241.
ISNAD Jayachandiran, Abirami Lakshmy et al. “A Study of Inducible Clindamycin Resistance Among Staphylococcus Aureus Skin and Soft Tissue Infections in A Tertiary Care Hospital”. Journal of Microbiology and Infectious Diseases 09/03 (September 2019), 125-128. https://doi.org/10.5799/jmid.614241.
JAMA Jayachandiran AL, Kandasamy B, Vilwanatha S, T. SDD, E. VD, Muralidharan V. A Study of Inducible Clindamycin Resistance among Staphylococcus aureus Skin and Soft Tissue Infections in A Tertiary Care Hospital. J Microbil Infect Dis. 2019;09:125–128.
MLA Jayachandiran, Abirami Lakshmy et al. “A Study of Inducible Clindamycin Resistance Among Staphylococcus Aureus Skin and Soft Tissue Infections in A Tertiary Care Hospital”. Journal of Microbiology and Infectious Diseases, vol. 09, no. 03, 2019, pp. 125-8, doi:10.5799/jmid.614241.
Vancouver Jayachandiran AL, Kandasamy B, Vilwanatha S, T. SDD, E. VD, Muralidharan V. A Study of Inducible Clindamycin Resistance among Staphylococcus aureus Skin and Soft Tissue Infections in A Tertiary Care Hospital. J Microbil Infect Dis. 2019;09(03):125-8.