Metisilin dirençli Staphylococcus aureus suşlarında indüklenebilir klindamisin direncinin araştırılması

Year 2017, Volume: 21 Issue: 2, 407 - 411, 01.05.2017

Hayrunisa Hancı Ahmet Ayyıldız Hakan İgan

Abstract

Klindamisin, Staphylococcus aureus enfeksiyonlarının

tedavisinde önemli alternatif antibiyotiklerden biridir. MRSA

tedavisinde seçeneklerin sınırlı olması doğru antibiyotik

seçiminin önemini artırmaktadır. Klindamisinin bu

enfeksiyonlarda kullanılmasındaki en önemli sorun, tedavinin

başarısızlığına sebep olabilen indüklenebilir klindamisin

direncinin varlığıdır. Bu çalışmanın amacı Atatürk Üniversitesi

Araştırma Hastanesi’nden izole edilen 86 MRSA suşunda

indüklenebilir klindamisin direnci varlığının araştırılmasıdır.

İndüklenebilir klindamisin direnci varlığı Clinical and

Laboratory Standards Institute (CLSI) önerileri doğrultusunda

D zon test yöntemi kullanılarak saptandı. Suşlardan 20’sinde

iMLSB, 8’inde cMLSB ve 22’sinde MS fenotipi görüldü. D

zon test MLSB fenotipinin saptanmasında eritromisin ve

klindamisin antibiyotik disklerini kullanarak yapılabilen basit

bir disk difüzyon testidir ve klinik laboratuvarlar tüm S. aureus izolatlarında indüklenebilir klindamisin direncini bildirmelidir.

Keywords

D zon test, indüklenebilir klindamisin direnci, MRSA

Investigation of inducible clindamycin resistance in methicillin resistant Staphylococcus aureus strains

Abstract

Clindamycin is one of the important alternative antibiotics in

the therapy of Staphylococcus aureus infections. The limited

treatment options for MRSA, increaes the importance of the

right antibiotic.The major problem of the use of clindamycin

for such infections is the presence of inducible clindamycin

resistance that can lead to treatment failure. The aim of this

study was to investigate the inducible clindamycin resistance

of 86 MRSA strains isolated from Research Hospital of Ataturk

University. Inducible clindamiycin resistance was detected

using D zone test method according to Clinical and Laboratory

Standards Institute (CLSI) instructions. Twenty of the strains

exhibited the iMLSB, 8 exhibited the cMLSB and 22 exhibited

the MS phenotype. The D zone test, which can be done by using

erythromycin and clindamycin discs, is a simple disc diffusion

test for detection MLSB phenotype and clinical laboratories

should report in vitro inducible clindamycin resistance in all S.

aureus isolates.

Keywords

D zone test, Inducible clindamycin resistance, MRSA

References

• 1. Shittu A, Oyedara O, Abegunrin F, Okon K, Raji A, TaiwoS, Ogunsola F, Onyedibe K, Elisha G. Characterization ofmethicillin-susceptible and resistant staphylococci in theclinical setting: a multicentre study in Nigeria. BMC InfectDis 2012; 12:286.
• 2. Vural A, Afşar İ, Kurultay N, Demirci M. Comparison of diskdiffusion, oxacillin agar screening, microdilution and pbp2alatex agglutination tests for detection of methicillin resistancein Staphylococcus aureus. Ankem Derg, 2011;25:145-9.
• 3. Farooq S, Saleem M. Prevalence of constıtutıve and inducıbleclindamycin resıstance among clinical isolates of Staph aureusin Kashmir valley: a hospital based study. J Evolution MedDent Sci 2016;5:828-31.
• 4. Uyanik MH, Yazgi H, Bilici D, Ozden K, Karakoc E. Detectionof macrolide-lincosamide-streptogramin B resistance innosocomial Staphylococcus aureus strains. Ankem Derg2009;23:66-70.
• 5. Mittal V. Kishore S, Siddique ME. Prevalence of inducibleclindamycin resistance among clinical isolates ofStaphylococcus aureus detected by phenotypic method: Apreliminary report. J Infect Dis Immun 2013;51:10-2.
• 6. Şamlıoğlu P, Ece G, Atalay S, Kose Ş. Macrolide-lincosamidestreptograminB (MLSB) resistance phenotypes instaphylococci isolated from clinical samples. Ankem Derg2012;26:116-9.
• 7. Tekin A, Dal T, Deveci O, Tekin R, Atmaca S, Dayan S.Assessment of methicillin and clindamycin resistance patternsin Staphylococcus aureus isolated from a tertiary hospital inTurkey. Infez Med 2013;2:111-6.
• 8. Shoji K, Shinjoh M, Horikoshi Y, Tang J, Watanabe Y, SugitaK, Tame T, Iwata S, Miyairi I, Saitoh A. High rate of inducibleclindamycin resistance in Staphylococcus aureus isolates-A multicenter study in Tokyo, Japan. J Infect Chemother2015;21:81-3.
• 9. Lewis JS 2nd, Jorgensen JH. Inducible clindamycin resistancein Staphylococci: should clinicians and microbiologists beconcerned? Clin Infect Dis 2005;40:280-5.
• 10. CLSI. Performance standards for antimicrobial susceptibilitytesting; twentysecond informational supplement. M100-S22.Wayne, PA: Clinical and Laboratory Standards Institute; 2012.
• 11. Sasirekha B, Usha MS, Amruta JA, Ankit S, Brinda N, Divya R.Incidence of constitutive and inducible clindamycin resistanceamong hospital-associated Staphylococcus aureus. 3 Biotech2014;4:85–9.
• 12. Sancak B. Staphylococcus aureus and antibiotic resistanceMikrobiyol Bul 2011;45: 565-76.
• 13. Doğan M, Feyzioğlu B, Baykan M. The change of antibioticresistance in S. aureus strains within ten year periods. AbantMed J 2014;3:237-41.
• 14. Gungor S, Uzun BK, Yurtsever SG, Baran N. Antibioticresistance in Staphylococcus aureus strains isolated from bloodcultures. Ankem Derg 2012; 26:171-5.
• 15. Haznedaroğlu T, Oncul O, Hoşbul T, Cavuşlu Ş, Baylan O,Ozyurt M. Methicillin resistance in Staphylococcus aureusstrains isolated from hospitalized patients: Three-year trend.TAF Prev Med Bull 2010;9:585-90.
• 16. Lall M, Sahni AK. Prevalence of inducible clindamycinresistance in Staphylococcus aureus isolated from clinicalsamples. Med J Armed Forces India 2014;70:43-7.
• 17. Mert Dinc B, Karabiber N, Aykut Arca E. Macrolidelincosamide-streptogramin b (MLSB) resistance and fusidicacid susceptibility of methicillin resistant Staphylococcusaureus (MRSA) strains isolated from clinical samples. TurkHij Den Biyol Derg 2009;66:89-94.
• 18. Dizbay M, Gunal O, Ozkan Y, Ozcan Kanat D, Altuncekic A,Arman D. Constitutive and inducible clindamycın resistanceamong nosocomially acquired staphylococci. Mikrobiyol Bul2008;42:217-21.
• 19. Mokta KK, Verma S, Chauhan D, Ganju SA, Singh D, Kanga A,Kumari A, Mehta V. Inducible clindamycin resistance amongclinical isolates of Staphylococcus aureus from Sub HimalayanRegion of India. J Clin Diagn Res 2015;9:20-3.
• 20. Juyal D, Shamanth AS, Pal S, Sharma MK, Prakash R, SharmaN. The prevalence of inducible clindamycin resistanceamong staphylococci in a tertiary care hospital - a study fromthe garhwal hills of uttarakhand, India. J Clin Diagn Res2013;7:61-5.
• 21. Sida H, Chauhan B, Pethani J, Patel L, Shah P. Inducibleclindamycin resistance among clinical isolates ofStaphylococcus aureus. Natl J Med Res 2015;5:268-71.
• 22. Fokas S, Fokas S, Tsironi M, Kalkani M, M. Prevalence of inducible clindamycin resistance inmacrolide-resistant Staphylococcus spp. Clin Microbiol Infect2005;11:337-40.
• 23. Schreckenberger PC, Ilendo E, Ristow KL. Incidenceof constitutive and inducible clindamycin resistance inStaphylococcus aureus and coagulase-negative staphylococciin a community and a tertiary care hospital. J Clin Microbiol2004;42:2777-9.
• 24. Siberry GK, Tekle T, Carroll K, Dick J. Failure of clindamycintreatment of methicillin-resistant Staphylococcus aureusexpressing inducible clindamycin resistance in vitro. ClinInfect Dis 2003;37:1257-60.
• 25. Saxena S, Singh T, Dutta R. Practical disk diffusion methodfor detection of inducible clindamycin resistance inStaphylococcus aureus at a tertiary care hospital: implicationsfor clinical therapy. J Commun Dis 2012;44:97-102.
• 26. Aydeniz Ozansoy F, Cevahir N, Kaleli I. Investigation ofmacrolide, lincosamide and streptogramin B resistance inStaphylococcus aureus strains isolated from clinical samplesby phenotypical and genotypical methods. Mikrobiyol Bul2015;49:1-14.
• 27. Eksi F, Gayyurhan ED, Bayram A, Karsligil T. Determinationof antimicrobial susceptibility patterns and inducibleclindamycin resistance in Staphylococcus aureus strainsrecovered from southeastern Turkey. J Microbiol ImmunolInfect 2011;44:57-62.
• 28. Kaskatepe B, Yıldız S. Determination of inducible clindamycinresistance in staphylococci strains isolated from clinicalsamples. Turk J Pharm Sci 2014;11:317-22.
• 29. Durmaz S, Kiraz A, Toka Ozer T, Percin D. Macrolidelincosamide-streptogramin B resistance phenotypes i