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

Year 2019, Volume: 09 Issue: 03, 125 - 128, 15.09.2019

Abirami Lakshmy Jayachandiran Balan Kandasamy Sangeetha Vilwanatha Sheila Doris Devami T. Vanitha Devi E. Vandhitha Muralidharan

https://doi.org/10.5799/jmid.614241

Cited By: 1

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.

Keywords

Methicillin resistant Staphylococcus aureus (MRSA), iMLSB resistance phenotype

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