Detection of constitutive and inducible clindamycin resistance of staphlococcus in a rural tertiary care hospital.
Manoja Kumar Das, H J Raj, Sukhendu Mandal, Gautam Mitra
Abstract
Manoja Kumar Das, H J Raj, Sukhendu Mandal, Gautam Mitra
Abstract
Clindamycin has gained immense importance in the treatment of Staphylococcal infections following resistance to Beta-lactam antibiotics, especially after emergence of Methicillin Resistant Staphylococcus aureus. Clindamycin is a valuable treatment option for Staphylococcal isolates that are erythromycin resistant and clindamycin sensitive. However following exposure to erythromycin, clindamycin sensitive strains may lead to constitutive clindamycin resistance and treatment failure. But labeling all erythromycin resistant Staphylococci as clindamycin resistant strain prevents its use in infections caused by true clindamycin sensitive strains. This study aims to detect the presence of inducible clindamycin resistance among clinical isolates of Staphylococci. The detection of inducible clindamycin resistance was performed by D-Test as per the NCCLS guidelines. Among two hundred clinical isolates of Staphylococci studied, there was 24% inducible Clindamycin resistance among all the Staphylococci isolates: 29.4% among Methicillin Resistant Staphylococcus aureus and 21% among Methicillin Sensitive Staphylococcus aureus. It is advisable to include inducible clindamycin resistance testing as part of routine antimicrobial susceptibility testing.
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Clindamycin has gained immense importance in the treatment of Staphylococcal infections following resistance to Beta-lactam antibiotics, especially after emergence of Methicillin Resistant Staphylococcus aureus. Clindamycin is a valuable treatment option for Staphylococcal isolates that are erythromycin resistant and clindamycin sensitive. However following exposure to erythromycin, clindamycin sensitive strains may lead to constitutive clindamycin resistance and treatment failure. But labeling all erythromycin resistant Staphylococci as clindamycin resistant strain prevents its use in infections caused by true clindamycin sensitive strains. This study aims to detect the presence of inducible clindamycin resistance among clinical isolates of Staphylococci. The detection of inducible clindamycin resistance was performed by D-Test as per the NCCLS guidelines. Among two hundred clinical isolates of Staphylococci studied, there was 24% inducible Clindamycin resistance among all the Staphylococci isolates: 29.4% among Methicillin Resistant Staphylococcus aureus and 21% among Methicillin Sensitive Staphylococcus aureus. It is advisable to include inducible clindamycin resistance testing as part of routine antimicrobial susceptibility testing.
Key concepts: Clindamycin, Erythromycin, Staphylococcus aureus, Microbiology, Medicine, Antibiotics, Antibiotic resistance, Staphylococcus