Detection of inducible clindamycin resistance in staphylococci by disk diffusion induction test.

OBJECTIVE: To detect inducible clindamycin (CL) resistance in staphylococci by disk diffusion induction test (D-test). MATERIAL AND METHOD: One thousand one hundred eighty clinical isolates of staphylococci were tested for inducible CL resistance by placing erythromycin (E) disk and clindamycin disk 12 mm apart (edge to edge) on Mueller-Hinton agar plate inoculated with staphylococci. The flattening of CL zone (D-shaped zone) near E disk indicated an inducible CL resistance was observed after 18-24 h of incubation. RESULTS: Inducible CL resistance was detected in 9.9% of staphylococci isolates. It was found in methicillin-resistant Staphylococcus aureus (MRSA) more than methicillin-sensitive Staphylococcus aureus (MSSA) and coagulase-negative staphylococci (CoNS) 35.9%, 4.7%, and 5.5%, respectively. CONCLUSION: To avoid misinterpretation of CL result, D-test is recommended for routine detecting of inducible CL resistance in staphylococci. It provides the confident laboratory report of CL as resistant (D-shaped zone positive) or as susceptible (D-shaped zone negative) particular for E resistant isolates.

Examination of diarrheal stools in Hat Yai City, South Thailand, for Escherichia coli O157 and other diarrheagenic Escherichia coli using immunomagnetic separation and PCR method.

A total of 493 stool samples from diarrheal patients in Songklanagarind Hospital, in southern Thailand, were examined for Escherichia coli O157 by the culture method combined with an immunomagnetic separation (IMS) technique. E. coli O157 was not found, although the IMS-based method could detect 10(2)-10(3) CFU of artificially inoculated O157/g of stool samples. Polymerase chain reaction was also used for the detection and identification of diarrheagenic E coli from 530 stool samples. The target genes were eae for enteropathogenic E. coli (EPEC), stx for enterohemorrhagic E. coli (EHEC), elt and est for enterotoxigenic E. coli (ETEC), ipaH for enteroinvasive E. coli (EIEC), and aggR for enteroaggregative E. coli (EAggEC). Fifty-eight diarrheagenic E. coli strains were detected in 55 stool samples (10%) from 32 children and 23 adults. These included 31 EAggEC strains (5.8%), 13 ETEC strains (2.5%), 13 EPEC strains (2.5%), and one EIEC strain (0.2%). EHEC was not detected. The diarrheagenic E. coli strains were found mainly in children under 2 years of age (24 of 32 children). EAggEC strains and ETEC strains were susceptible to several antibiotics whereas the EPEC strains exhibited resistance to these antibiotics.