scholarly journals Detection of inducible clindamycin resistance in Staphylococcus aureus from various samples in a tertiary care hospital

2019 ◽  
Vol 7 (12) ◽  
pp. 4696
Author(s):  
Rohit Kumar ◽  
Jagarti . ◽  
Mrinmoy Sarma ◽  
Gautam Shalini
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Sensitivity Testing ◽  
Inducible Clindamycin Resistance

Background: The increasing frequency of MRSA infections and rapidly changing patterns in antimicrobial resistance, led to renewed interest in the usage of Macrolides-Lincosamide-Streptogramin B (MLSB) antibiotics to treat Staphylococcus aureus infection. Clindamycin is an important drug used in the treatment of MRSA and MSSA infection. The aim of this study was to determine inducible and constitutive clindamycin resistance among clinical isolates of Staphylococcus aureus by D-test.Methods: During a period of 6 months from July 2018 to December 2018, a total of 100 Staphylococcus aureus isolated from different clinical samples were subjected to routine antibiotic sensitivity testing by Kirby Bauer’s disc diffusion method. Methicillin-resistance was determined by using the cefoxitin (30 µg) disc. Incidence of MLSBc and MLSBi in Staphylococcus aureus isolates by D-test as per CLSI guidelines.Results: Out of 100 isolates of Staphylococcus aureus obtained from 350 clinical samples, 70(70%) were found to be MRSA and 30(30%) were MSSA. Among 100 Staphylococcus aureus isolates, 40% isolates showed MLSBi resistance, 28% isolates showed MLSBc resistance, 6% isolates showed MS phenotype and 26% isolates showed Sensitive phenotype. MLSBc and MLSBi were found to be higher in MRSA as compared to MSSA (21%, 27% and 7%, 10% respectively). All clinical isolates showed 100% sensitivity to Vancomycin and Linezolid in routine antibiotic susceptibility testing.Conclusions: Continuous surveillance of the MLSB resistance is important and required before the prescription of clindamycin to treat MRSA infections.

scholarly journals Susceptibility of Clinical Isolates of Staphylococcus aureus to Ceftaroline

2021 ◽  
Author(s):  
Harsha Sreedharan ◽  
KB Asha Pai
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care Hospital ◽  
Methicillin Resistance ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
The United States ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital

Introduction: Methicillin-Resistant Staphylococcus aureus(MRSA) infection is a major global healthcare problem, the prevalence of which varies from 25-50% in India. It is known to cause Skin and Soft tissue Infections (SSI), endovascular infections, endocarditis, pneumonia, septic arthritis, osteomyelitis, and sepsis. Vancomycin is the drug of choice for treating severe MRSA infections. Ceftaroline, a fifth-generation cephalosporin has been approved by the United States Food and Drug Administration (US FDA) for treating acute bacterial SSI caused by susceptible micro-organisms including MRSA, Community acquired respiratory tract infection, MRSA bacteremia and endocarditis. Aim: To assess the susceptibility of clinical isolates of S. aureusto ceftaroline, in a Tertiary Care Hospital. Materials and Methods: This prospective study was conducted in the Department of Microbiology of a Tertiary Care Hospital over a period of two months from June 2019 to July 2019. S.aureus isolates from various clinical samples were screened for methicillin resistance by disc diffusion method using cefoxitin disc and ceftaroline susceptibility of these isolates was assessed by E-strip method. The isolates were classified as ceftaroline susceptible, Susceptibility Dose Dependent (SDD) and ceftaroline resistant respectively as per CLSI guidelines. A descriptive analysis of the data was done and the results were presented as frequencies and percentages. Results: All the S.aureus isolates were found to be susceptible to ceftaroline. Methicillin Sensitive Staphylococcus aureus(MSSA) isolates had lower Minimum Inhibitory Concentration (MIC) when compared to MRSA. The highest MIC among MRSA was 0.5 μg/mL. Conclusion: Ceftaroline can be considered as an effective alternative for treatment of infections caused by MRSA.

Phenotypic Detection of Inducible Clindamycin Resistance among Clinical Isolates of Staphylococcus aureus in Bharatpur Hospital

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Ramesh Sharma Regmi ◽  
Sujan Khadka ◽  
Sanjeep Sapkota ◽  
Swekshya Thapa Magar ◽  
Sanjib Adhikari ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Treatment Failure ◽  
Tertiary Care ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Disc Diffusion ◽  
Cross Sectional ◽  
Inducible Clindamycin Resistance

Background: Clindamycin is regarded as a reserve drug in the treatment of staphylococcal infections. Among few therapeutic alternatives available for treatment of erythromycin-resistant Staphylococcus aureus infections, clindamycin has several advantages but major limitation in its use is the development of resistance resulting in treatment failure. Routine clindamycin susceptibility test may fail to detect such inducible resistance which can be detected by Double disc diffusion test (D-test). The present study was undertaken to determine the incidence of inducible clindamycin resistance among clinical isolates of S. aureus in a tertiary care hospital in central Nepal. Methods: A cross-sectional study was carried out among the patients visiting Bharatpur Hospital from September to November 2019. A total of 1279 clinical samples were examined for the identification of S. aureus by standard microbiological procedures. Antibiotic susceptibility testing of the isolates was done by Kirby-Bauer disc diffusion method and all the erythromycin-resistant isolates were subjected to D-test for the phenotypic detection of inducible clindamycin resistance according to CLSI guidelines (2016). Results: S. aureus was recovered from 4.5% (58/1279) samples of which 35 isolates were Methicillin-Resistant Staphylococcus aureus (MRSA) and 23 were multi-drug resistant (MDR). Tetracycline was found to be the most effective antibiotic whereas erythromycin was the least effective. D-test revealed that 39.7% isolates showed iMLSB phenotype, 3.5% showed cMLSB phenotype and 56.8% showed MS phenotype. The percentage of inducible and constitutive resistance was seen higher amongst MRSA isolates compared to Methicillin-Sensitive Staphylococcus aureus (MSSA) isolates. Incidence of S. aureus was found higher among females and in the age group 20-30 years and in pus samples (p<0.01). Conclusions: Routine testing of inducible clindamycin resistance is suggested among the clinical isolates of erythromycin-resistant Staphylococci to avoid treatment failure.  

scholarly journals Prevalence of constitutive and inducible clindamycin resistance among clinical isolates of Staphylococcus aureus in a tertiary care institute in North India

2017 ◽  
Vol 5 (7) ◽  
pp. 3120
Author(s):  
Jeevan Shetty ◽  
Zarrin Afroz
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Susceptibility Testing ◽  
Tertiary Care ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Antibiotic Susceptibility Testing ◽  
Sensitivity Testing ◽  
Inducible Clindamycin Resistance

Background: Clindamycin is an important drug used in the treatment of Methicillin Sensitive Staphylococcus aureus (MSSA) as well as in Methicillin-resistant Staphylococcus aureus (MRSA) infections. This drug is widely used in the treatment of skin and soft tissue infections caused by them. Therapeutic failure caused by macrolide-lincosamine-streptogramin B constitutive and inducible clindamycin resistance (MLSBc and MLSBi) is being more commonly reported.Methods: The present study was conducted over a period of six months from October 2016 to March 2017 to know the incidence of MLSBc and MLSBi in Staphylococcus aureus (S. aureus) isolates obtained in our hospital by D-test as per CLSI guidelines. A total of 130 isolates of S.aureus were obtained from different clinical specimens which included pus/ wound swab (n=266), urine (n=577), sputum (n=225), blood (n=221), throat swab (n=71), ear/eye discharge (n=21), high vaginal swab (n=20) and body fluids (n=50). All the isolates were subjected to antibiotic sensitivity testing by Kirby Bauer’s disc diffusion method. Amoxyclav, Erythromycin, Clindamycin, Co-trimoxazole, Tetracycline, Ofloxacin, Gentamicin, Linezolid and Vancomycin were the antibiotics used.Results: Out of 130 (8.9%) isolates of S. aureus obtained from 1451 clinical samples, 82 (63.1%) were found to be MSSA and 48 (36.9%) were MRSA. Among S. aureus, 43 (33.1%) isolates showed MLSBc resistance, 22 (16.9%) isolates showed MLSBi resistance and 20 (15.4%) isolates showed MS phenotype. The remaining 45 (34.6%) isolates remained sensitive to Erythromycin. Among MSSA, MLSBc were observed in 18 (22%) isolates and MLSBi in 9 (11%) while in MRSA, MLSBc were observed in 25 (52.1%) isolates and MLSBi in 13 (27.1%) isolates. Almost all clinical isolates showed 100% sensitivity to Vancomycin and Linezolid in routine antibiotic susceptibility testing. Both MLSBc and MLSBi resistance was significantly higher (p<0.05) in MRSA than in MSSA.Conclusions: The study emphasizes the importance of conducting D test along with routine antibiotic susceptibility testing for better utilization of clindamycin in S. aureus infections.

scholarly journals Prevalence of inducible clindamycin resistance in erythromycin resistant clinical isolates of Staphylococcus aureus and CONS at tertiary care hospital

2016 ◽  
Vol 12 (3) ◽  
pp. 83-88
Author(s):  
Sangita Thapa ◽  
Lokendra Bahadur Sapkota
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Current Trend ◽  
Clinical Isolates ◽  
Clinical Samples ◽  
Care Hospital ◽  
Erythromycin Resistance ◽  
Inducible Clindamycin Resistance ◽  
Microbiological Methods

Background & Objectives: The objective of this study was to isolate and identify Staphylococcus species from different samples clinical samples and to determine the current trend regarding the incidence and distribution of inducible clindamycin resistance in clinical isolates of Staphylococcus aureus and CONS.Materials & Methods: A total of 264 isolates of staphylococcus species were isolated from various clinical samples. Clinical samples were cultured and Staphylococcus species were identified using standard microbiological methods recommended by the American Society for Microbiology (ASM). Methicillin resistance was confirmed using cefoxitin and oxacillin disks. Inducible clindamycin resistance was identified using D-zone test.Results: Among 264 erythromycin resistant staphylococcus species, 213 (80.6%) were S. aureus and 51 (19.3%) were CONS. Out of 213 erythromycin resistant isolates of S. aureus, 140 (65.7%) were MRSA and 73 (34.2%) were MSSA whereas out of 51 erythromycin resistant isolates of CONS, 28 (54.9%) were MRCNS and 23 (45%) were MSCNS. Constitutive MLSB phenotype and Inducible MLSB phenotype was higher among both MRSA and MRCNS isolates. MS phenotype was more predominant among 11 (5.1%) MSSA and 5 (9.8%) MSCNS isolates compared to 9 (4.2%) in MRSA and 2 (3.9%) in MRCNS.Conclusion: The prevalence of constitutive & inducible clindamycin resistance in staphylococcus isolates was high among both MRSA and MRCNS. Hence the implementation of D-test routinely, will reveal the iMLSB & cMLSB phenotype & will guide the clinicians whether to use clindamycin in staphylococcal infections when erythromycin resistance is present.

scholarly journals Phenotypic detection of inducible clindamycin resistance among Staphylococcus aureus isolates

2017 ◽  
Vol 5 (2) ◽  
pp. 543 ◽  
Author(s):  
Archana P. Nikam ◽  
Pramod R. Bhise ◽  
Mukta M. Deshmukh
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Therapeutic Option ◽  
Antibiotic Sensitivity ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Sensitivity Testing ◽  
Inducible Clindamycin Resistance ◽  
Constitutive Resistance ◽  
The Relationship

Background: Staphylococcus aureus is a leading cause of nosocomial and community acquired infection in every region of world. Clindamycin is a frequent therapeutic option in the treatment of skin and soft tissue infection caused by Staphylococcus aureus. However resistance to this drug is again a problem which may be inducible or constitutive. The present study was carried out to determine the prevalence of inducible clindamycin resistance among Staphylococcus aureus and to find out the relationship between methicillin resistant Staphylococcus aureus and inducible clindamycin resistance.Methods: A total of 177 Staphylococcus aureus isolated from different clinical samples were subjected to routine antibiotic sensitivity testing by Kirby Bauer disc diffusion method. All were tested for Methicillin resistance by using cefoxitin 30 µg disc. Inducible clindamycin resistance was detected by ‘D’ test as per CLSI guidelines.Results: Out of the 177 Staphylococcus aureus isolates, 77 (43.50%) were MRSA and 100 (56.50%) were MSSA. 101 (57.06%) isolates were erythromycin resistant. These erythromycin resistant isolates when subjected to ‘D’ test, 27 isolates showed MS phenotype, 26 showed inducible MLSB phenotype and 48 showed constitutive MLSB phenotype. Out of 77 MRSA isolates 23 (29.87%) showed Inducible MLSB phenotype and 33 (42.85%) showed Constitutive MLSB phenotype, while in 100 methicillin sensitive Staphylococcal isolates 03 (3%) showed Inducible MLSB phenotype and 15 (15%) showed Constitutive MLSB phenotype. The percentage of inducible and constitutive resistance was higher amongst MRSA isolates as compared to MSSA isolates.Conclusions: Study showed that ‘D’ test should be used routinely to detect inducible clindamycin resistance.

scholarly journals Prevalence of Methicillin-resistant Staphylococcus Aureus (MRSA) in a Tertiary Care Hospital in Northern India

2010 ◽  
Vol 2 (02) ◽  
pp. 078-081 ◽  
Author(s):  
Shilpa Arora ◽  
Pushpa Devi ◽  
Usha Arora ◽  
Bimla Devi
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Diffusion Method ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
Sensitivity Pattern

ABSTRACT Aim: The emergence of Methicillin-resistant Staphylococcus aureus (MRSA) has posed a serious therapeutic challenge. We report the prevalence and antibiotic susceptibility pattern of MRSA in the hospitals attached to GMC, Amritsar, Punjab. Materials and Methods: The study comprised of 250 coagulase-positive staphylococci (COPS) isolated from a total of 6743 clinical specimens (like pus, blood, urine, high vaginal swab, sputum, etc.) of patients admitted in hospitals attached to Government Medical College, Amritsar from January 2008−February 2009. Routine antibiotic susceptibility testing was performed and interpreted as per standard guidelines. Methicillin resistance was detected using oxacillin and cefoxitin disc diffusion method, oxacillin screen agar method, and minimum inhibitory concentration using broth macrodilution method. Results: A total of 115 (46%) strains were found to be methicillin resistant. Multidrug resistance was observed in 73% MRSA strains. However, no strain was resistant to vancomycin. Conclusion: Regular surveillance of hospital-associated infection and monitoring of antibiotic sensitivity pattern is required to reduce MRSA prevalence.

scholarly journals Prevalence of ESBL and MBL Producing Acinetobacter species Isolated from Various Clinical Samples in Tertiary Care Hospital in North-West Region of Rajasthan

2021 ◽  
Vol 10 (10) ◽  
pp. 524-532
Author(s):  
Sumitra Kumari Sanju Pannu ◽  
Anjli Gupta Geeta Tinna ◽  
B.P. Sharma
Keyword(s):  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Sensitivity Testing ◽  
Acinetobacter Species ◽  
North West ◽  
Medical College ◽  
Vaginal Swabs

This study was conducted with an objective to find the prevalence of extended spectrum betalactamase (ESBL) and metallo betalactamase (MBL) in Acinetobacter species. It was conducted in the Department of Microbiology, Sardar Patel Medical college, Bikaner from Feb 2018 to Feb.2019. in various clinical specimens including urine, pus, blood, vaginal swabs, respiratory samples, and various body fluids were processed Acinetobacter species isolates were identified by standard protocols. Antibiotic sensitivity testing for all isolates was done using Kirby-Bauer disc diffusion method. Disc potentiation test was performed to check ESBL and MBL production in these bacteria. Maximum ESBL and MBL positive isolates of Acinetobacter species were observed among E.T. tube samples. Early detection, stringent antibiotic policies, and compliance towards infection control practices are the best defenses against this organisms.

scholarly journals Characteristics of Staphylococcus aureus Isolated From Clinical Specimens in a Tertiary Care Hospital, Kathmandu, Nepal

2020 ◽  
Vol 13 ◽  
pp. 117863612097269
Author(s):  
Shesh Narayan Kandel ◽  
Nabaraj Adhikari ◽  
Binod Dhungel ◽  
Upendra Thapa Shrestha ◽  
Khadga Bikram Angbuhang ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Meca Gene ◽  
Significant Proportion ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Clinical Specimens ◽  
Culture Positive

Introduction: Methicillin resistant Staphylococcus aureus (MRSA) is a major human pathogen associated with nosocomial and community infections. mecA gene is considered one of the important virulence factors of S. aureus responsible for acquiring resistance against methicillin. The main objective of this study was to explore the prevalence, antibiotic susceptibility pattern, and mec A gene. Methods: A total of 39 isolates of S. aureus were isolated from 954 clinical specimens processed in Microbiology laboratory of Himal Hospital, Kathmandu. Antimicrobial susceptibility test (AST) was performed by Kirby-Bauer disc diffusion method using cefoxitin, and performed Polymerase Chain Reaction (PCR) for amplification of mecA gene in MRSA isolates. Results: Out of 954 clinical samples, (16.2%; 153/954) samples had bacterial growth. Among 153 culture positive isolates, 25.5% (39/153) were positive for S. aureus. Among 39 S. aureus (61.5%; 24/39) were multiple drug resistant (MDR). On AST, amoxicillin was detected as the least effective while vancomycin was the most effective. The prevalence of methicillin resistance was 46% (18/39) of which 72.2% (13/18) were positive for mecA gene in PCR assay. Conclusion: One in 4 culture positive isolates from the clinical specimens were S. aureus, of which almost two-thirds were MDR. Around half of the MDR showed MRSA and significant proportion of them were positive for mecA gene. This study concludes that the mecA gene is solely dependent for methicillin resistance in S. aureus but the presence of gene is not obligatory. PCR detection of the mecA gene is reliable, valid and can be suggested for the routine use in diagnostic laboratories.

scholarly journals Staphylococcus aureus with inducible clindamycin resistance and methicillin resistance in a tertiary hospital in Nepal

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Devi Thapa ◽  
Susil Pyakurel ◽  
Sabita Thapa ◽  
Suresh Lamsal ◽  
Mahesh Chaudhari ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Susceptibility Testing ◽  
Methicillin Resistance ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Antibiotic Susceptibility Testing ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance

Abstract Background Staphylococcus aureus is a global public health issue in both community and hospital settings. Management of methicillin-resistant S. aureus (MRSA) infections are tough owing to its resistance to many antibiotics. Macrolide-lincosamide-streptogramin B (MLSB) antibiotics are commonly used for the management of MRSA. This study was aimed to determine the occurrence of inducible clindamycin- and methicillin-resistant S. aureus at a tertiary care hospital in Kathmandu, Nepal. Methods A total of 1027 clinical samples were processed following standard laboratory procedures and antibiotic susceptibility testing of S. aureus was performed by disc diffusion method. MRSA isolates were detected phenotypically using cefoxitin disc, and inducible clindamycin resistance was detected phenotypically using the D-zone test. Results Of 1027 samples, 321 (31.2%) were culture positive, of which 38 (11.8%) were S. aureus. All S. aureus isolates were susceptible to vancomycin, and 25 (67%) of S. aureus isolates were multidrug-resistant. Similarly, 15 (39.5%) of S. aureus were MRSA and 14 (36.5%) were inducible clindamycin-resistant phenotypes. Conclusion Inducible clindamycin and methicillin resistance were common in S. aureus. This emphasizes that the methicillin resistance test and the D-zone test should be incorporated into the routine antibiotic susceptibility testing in hospital settings.

scholarly journals TO STUDY ANTIBIOTIC SENSITIVITY PATTERN OF NONFERMENTATIVE GRAM NEGATIVE BACILLI FROM VARIOUS CLINICAL SAMPLES IN A TERTIARY CARE HOSPITAL, JAIPUR.

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Kirti Hemwani ◽  
P. S. Nirwan ◽  
Preeti Shrivastava ◽  
Abhiraj Ramchandani
Keyword(s):  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Polymyxin B ◽  
Hospital Environment ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Pathogenic Potential ◽  
Gram Negative ◽  
Sensitivity Pattern

Background: Nonfermentative gram negative bacilli (NFGNB) frequently considered as commensals or contaminants but the pathogenic potential of nonfermenters has been proved beyond doubt. They are resistant to commonly used antimicrobials. Aim: This study was undertaken to identify the nonfermenters isolated from various clinical samples and to know their Antibiotic sensitivity pattern. Materials and Methods: The present study was carried out on 150 strains of Nonfermenters isolated from 1200 various non repetitive clinical samples received in Department of Microbiology, NIMS Jaipur. Nonfermenters were identified using a standard protocol and their antibiotic susceptibility testing was performed with the help of the modified Bauer disc diffusion method. Results: Out of 150 nonfermenters isolated, Pseudomonas aeruginosa was the most common isolate 134 (89.33%) followed by Acinetobacter baumannii 16 (10.67%). Among all clinical samples Pus and Wound Discharge yield maximum isolates of NFGNB i.e. 54 (36%) % followed by sputum (39.0%). Most sensitive drug against NFGNB was Polymyxin-B (100%) followed by Imipenem (86 %) and Amikacin (71.33 %). Conclusion: Nonfermenters have a great potential to survive in a hospital environment so implementation of antibiotic stewardship programs and strict infection control practices will be required to prevent or slow down their emergence and spread. Keywords:  Nonfermenters,  Polymyxin-B, Pseudomonas, Acinetobacter.

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