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ISSN: 2394-4137 (E) 2394-6318 (P)

IJIMS.2017.104

Type of Article: Original Research

Volume 4; Issue 3: 2017

Page No.: 472-475

DOI: 10.16965/ijims.2017.104

Inducible Clindamycin resistance among clinical isolates of

Staphylococcus aureus at a Rural tertiary care teaching hospital of

western Uttarpradesh

Abhishek Mehta *, Vijay Prakash Singh.

Department of Microbiology, K.D. Medical College Hospital & Research Center , Mathura, Uttar Pradesh, India.

Corresponding Author: Dr.Abhishek Mehta, Department of Microbiology, KD Medical College, Hospital & Research Center, 24 Km.milestone, NH#2, AKBARPUR-281406, Distt.Mathura (UP), India. Phone: +91-9897620394
E-Mail: abhishekmehta623@gmail.com

ABSTRACT

Background: Staphylococcus aureus a notorious pathogen is rapidly acquiring resistance against most of the major group of antibiotics including Clindamycin. Inducible Clindamycin resistance is difficult to detect and is often missed in routine antibiotic susceptibility testing. Prompt and timely detection of such resistance in the clinical isolates of S.aureus is imperative to formulate appropriate strategy for the effective treatment of such infections.

Aims & Objectives: To determine the percentage of inducible Clindamycin resistance among clinical isolates of S.aureus in our geographical area using D-test and to distinguish  different susceptibility patterns/resistance phenotypes in Erythromycin resistant clinical isolates of S.aureus.

Materials and Methods: A total of 244 consecutive non-duplicate isolates of S.aureus recovered from various clinical specimens (Urine, pus, wound swab, blood, body fluids, aspirates etc.) were subjected to Antibiotic Susceptibility Testing by Standard disc diffusion method and Methicillin resistance testing using Cefoxitin disc (30μgm). Erythromycin resistant S.aureus isolates were subjected to D-test as per CLSI 2014 guidelines.

Result: Out of 244 clinical isolates of S.aureus, 49(20%) were found to be MRSA and 195(80%) MSSA strains. 74(30.33%) were Erythromycin resistant and were subjected to D-test.16 isolates(6.56%) exhibited resistance against both Erythromycin and Clindamycin indicative of Constitutive cMLSB  phenotype, 21(8.6%) were found to be D-test positive for inducible resistance(iMLSB phenotype) while 39(15.98%) were D-test negative and hence truly susceptible to Clindamycin(MS phenotype).

Conclusion: The observations of this study had clearly revealed that if D-test would’ve not been performed then a significant proportion of Erythromycin resistant isolates would have been reported wrongly as Clindamycin sensitive and this could have resulted in the treatment failure.So,D-test must be incorporated in routine Antibiotic susceptibility testing for S.aureus isolates so as to ensure the judicious and rational use of this valuable drug.

Key words: D-Test, Methicillin Resistant Staphylococcus aureus (MRSA) Methicillin Sensitive Staphylococcus aureus (MSSA), Constitutive Macrolide Lincosamide Streptogramin B Phenotype (cMLSB), Inducible Macrolide Lincosamide Streptogramin B Phenotype (iMLSB), MS phenotype.

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