Prevalence of Inducible Clindamycin Resistance in Staphylococcus: A Study from a Rural Teaching Tertiary Care Hospital in Southern Haryana
Introduction: Clindamycin is the most commonly prescribed Macrolides, Lincosamides and Streptogramin-B (MLSB) antibiotics to treat staphylococcal infections. It has excellent pharmacokinetic properties. Staphylococcus species shows either constitutive (MLSBc) or inducible (MLSBi) clindamycin re...
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doaj-e858a0054e8f451697a909cecd68bd332021-07-10T08:09:47ZengJCDR Research and Publications Pvt. Ltd.National Journal of Laboratory Medicine2277-85512455-68822021-04-01102MO06MO0910.7860/NJLM/2021/46903:2461Prevalence of Inducible Clindamycin Resistance in Staphylococcus: A Study from a Rural Teaching Tertiary Care Hospital in Southern Haryana Pratibha Mane0Pooja Singla1Jyoti Sangwan2Professor and Head, Department of Microbiology, SHKM, GMC, Nuh, Haryana, India.Assistant Professor, Department of Microbiology, SHKM, GMC, Nuh, Haryana, India.Associate Professor, Department of Microbiology, SHKM, GMC, Nuh, Haryana, IndiaIntroduction: Clindamycin is the most commonly prescribed Macrolides, Lincosamides and Streptogramin-B (MLSB) antibiotics to treat staphylococcal infections. It has excellent pharmacokinetic properties. Staphylococcus species shows either constitutive (MLSBc) or inducible (MLSBi) clindamycin resistance. Routine D-test recommended by Clinical Laboratory and Standard Institute (CLSI) can detect MLSBi phenotype and prevent treatment failure. Aim: To identify inducible clindamycin resistance in Staphylococci in a rural teaching Tertiary Care Hospital. Materials and Methods: It was a prospective, cross-sectional study. The clinical samples were cultured on blood agar and MacConkey agar. Staphylococcus isolates were identified based on their colony characteristics, gram stain and standard biochemical test. Antimicrobial susceptibility test was performed by Kirby Bauer’s disc diffusion method. To detect Methicillin resistance Cefoxitin disc (30 μg) was used. The isolates that were Erythromycin resistant and Clindamycin sensitive were further subjected to D test. CLSI 2019 guidelines were followed for performing the tests and its interpretation. Epi-info (version 7.2.3.1) Centre for Disease Control and Prevention (CDC), Atlanta, Georgia was used to analyse the data and interpretation of the results. Results: Total 150 Staphylococci were isolated from different samples. Staphylococcus aureus were 70% and Coagulase negative Staphylococcus (CoNS) were 30%. Pus was the most common specimen from which 43% Staphylococci was isolated. Sensitivity to vancomycin and linezolid were 100%. Staphylococcus aureus (38%) and CoNS (33%) were Methicillin resistant. Overall (63%) of staphylococcus isolates were resistant to erythromycin. The different susceptibility patterns to clindamycin in both Staphylococcus aureus and CoNS were noted. MLSBc phenotype was most prevalent (37.3%) followed by MS (13.4%) and MLSBi (12%) among erythromycin resistant Staphylococcus isolate. Sensitive (S) phenotype was detected in 56 (37%). MLSBi was more frequent in Methicillin Resistant Staphylococcus aureus (MRSA) (23%) and MRCoNS (27%) than in MSSA (5%) and MSCoNS (7%). Conclusion: D-test should be performed routinely to avoid false susceptible results leading to treatment failure.http://www.njlm.net/articles/PDF/2461/46903_CE[Ra]_F(Sh)_PF1_(AG_OM)_PFA(SHU)_PN(SHU).pdfdisc approximation testmacrolidesinducible macrolideslincosamidesstreptogramin-b |
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language |
English |
format |
Article |
sources |
DOAJ |
author |
Pratibha Mane Pooja Singla Jyoti Sangwan |
spellingShingle |
Pratibha Mane Pooja Singla Jyoti Sangwan Prevalence of Inducible Clindamycin Resistance in Staphylococcus: A Study from a Rural Teaching Tertiary Care Hospital in Southern Haryana National Journal of Laboratory Medicine disc approximation test macrolides inducible macrolides lincosamides streptogramin-b |
author_facet |
Pratibha Mane Pooja Singla Jyoti Sangwan |
author_sort |
Pratibha Mane |
title |
Prevalence of Inducible Clindamycin Resistance in Staphylococcus: A Study from a Rural Teaching Tertiary Care Hospital in Southern Haryana |
title_short |
Prevalence of Inducible Clindamycin Resistance in Staphylococcus: A Study from a Rural Teaching Tertiary Care Hospital in Southern Haryana |
title_full |
Prevalence of Inducible Clindamycin Resistance in Staphylococcus: A Study from a Rural Teaching Tertiary Care Hospital in Southern Haryana |
title_fullStr |
Prevalence of Inducible Clindamycin Resistance in Staphylococcus: A Study from a Rural Teaching Tertiary Care Hospital in Southern Haryana |
title_full_unstemmed |
Prevalence of Inducible Clindamycin Resistance in Staphylococcus: A Study from a Rural Teaching Tertiary Care Hospital in Southern Haryana |
title_sort |
prevalence of inducible clindamycin resistance in staphylococcus: a study from a rural teaching tertiary care hospital in southern haryana |
publisher |
JCDR Research and Publications Pvt. Ltd. |
series |
National Journal of Laboratory Medicine |
issn |
2277-8551 2455-6882 |
publishDate |
2021-04-01 |
description |
Introduction: Clindamycin is the most commonly prescribed
Macrolides, Lincosamides and Streptogramin-B (MLSB)
antibiotics to treat staphylococcal infections. It has excellent
pharmacokinetic properties. Staphylococcus species shows
either constitutive (MLSBc) or inducible (MLSBi) clindamycin
resistance. Routine D-test recommended by Clinical Laboratory
and Standard Institute (CLSI) can detect MLSBi phenotype and
prevent treatment failure.
Aim: To identify inducible clindamycin resistance in
Staphylococci in a rural teaching Tertiary Care Hospital.
Materials and Methods: It was a prospective, cross-sectional
study. The clinical samples were cultured on blood agar and
MacConkey agar. Staphylococcus isolates were identified
based on their colony characteristics, gram stain and standard
biochemical test. Antimicrobial susceptibility test was performed
by Kirby Bauer’s disc diffusion method. To detect Methicillin
resistance Cefoxitin disc (30 μg) was used. The isolates that were
Erythromycin resistant and Clindamycin sensitive were further
subjected to D test. CLSI 2019 guidelines were followed for
performing the tests and its interpretation. Epi-info (version 7.2.3.1)
Centre for Disease Control and Prevention (CDC), Atlanta, Georgia
was used to analyse the data and interpretation of the results.
Results: Total 150 Staphylococci were isolated from different
samples. Staphylococcus aureus were 70% and Coagulase
negative Staphylococcus (CoNS) were 30%. Pus was the
most common specimen from which 43% Staphylococci was
isolated. Sensitivity to vancomycin and linezolid were 100%.
Staphylococcus aureus (38%) and CoNS (33%) were Methicillin
resistant. Overall (63%) of staphylococcus isolates were
resistant to erythromycin. The different susceptibility patterns
to clindamycin in both Staphylococcus aureus and CoNS were
noted. MLSBc phenotype was most prevalent (37.3%) followed
by MS (13.4%) and MLSBi (12%) among erythromycin resistant
Staphylococcus isolate. Sensitive (S) phenotype was detected
in 56 (37%). MLSBi was more frequent in Methicillin Resistant
Staphylococcus aureus (MRSA) (23%) and MRCoNS (27%) than
in MSSA (5%) and MSCoNS (7%).
Conclusion: D-test should be performed routinely to avoid false
susceptible results leading to treatment failure. |
topic |
disc approximation test macrolides inducible macrolides lincosamides streptogramin-b |
url |
http://www.njlm.net/articles/PDF/2461/46903_CE[Ra]_F(Sh)_PF1_(AG_OM)_PFA(SHU)_PN(SHU).pdf |
work_keys_str_mv |
AT pratibhamane prevalenceofinducibleclindamycinresistanceinstaphylococcusastudyfromaruralteachingtertiarycarehospitalinsouthernharyana AT poojasingla prevalenceofinducibleclindamycinresistanceinstaphylococcusastudyfromaruralteachingtertiarycarehospitalinsouthernharyana AT jyotisangwan prevalenceofinducibleclindamycinresistanceinstaphylococcusastudyfromaruralteachingtertiarycarehospitalinsouthernharyana |
_version_ |
1721309987806904320 |