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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 Jul-Sep; 51(3): 376-8
Article in English | IMSEAR | ID: sea-74565
ABSTRACT
CONTEXT Clindamycin is one of the important alternative antibiotics in the therapy of Staphylococcus aureus, particularly in methicillin-resistant S. aureus (MRSA) infections. Inducible clindamycin resistance (iMLS B--inducible Macrolide-Lincosamide-Streptogramin B resistance) is a critical factor in antimicrobial susceptibility testing.

AIMS:

To know the rate of inducible clindamycin resistance among clinical isolates of Staphylococcus aureus in our hospital by Disk approximation test (D-test) using the average recommended inter-disk distance and comparing the results with that of D-test using the lower limit of recommended inter-disk distance. MATERIALS AND

METHODS:

A total of 51 erythromycin-resistant and clindamycin-susceptible S. aureus isolates were subjected to disk approximation testing with 21 +/- 1 mm and 15 mm edge-to-edge distance between the clindamycin and erythromycin disks. STATISTICAL

METHODS:

Z-test levels.

RESULTS:

Among 51 erythromycin-resistant and clindamycin-susceptible S. aureus isolates, 25 (49%) were recorded as inducible clindamycin resistant by D-test with 21 +/- 1 mm edge-to-edge distance between the clindamycin and erythromycin disks. When we re-tested all the 51 strains by D-test with 15 mm inter-disk distance, we identified 14% more iMLS B strains previously reported as D-test negative. Z-test for MRSA indicates that 15 mm edge-to-edge distance has significant advantage.

CONCLUSIONS:

Since the incidence of inducible clindamycin resistance is high (63% in our study), accurate identification of inducible clindamycin resistance is important to prevent therapeutic failure in infections caused by these strains. We suggest the use of D-test with 15 mm edge-to-edge inter-disk distance for detecting iMLS B .
Subject(s)
Full text: Available Index: IMSEAR (South-East Asia) Main subject: Staphylococcus aureus / Humans / Clindamycin / Microbial Sensitivity Tests / Sensitivity and Specificity / Drug Resistance, Bacterial / Anti-Bacterial Agents Type of study: Diagnostic study / Evaluation studies / Prognostic study Language: English Journal: Indian J Pathol Microbiol Year: 2008 Type: Article

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Full text: Available Index: IMSEAR (South-East Asia) Main subject: Staphylococcus aureus / Humans / Clindamycin / Microbial Sensitivity Tests / Sensitivity and Specificity / Drug Resistance, Bacterial / Anti-Bacterial Agents Type of study: Diagnostic study / Evaluation studies / Prognostic study Language: English Journal: Indian J Pathol Microbiol Year: 2008 Type: Article