Determine Constitutive and Inducible Clindamycin Resistance among Clinical Isolates of Staphylococcus Aureus Isolates from Tertiary Care Hospital, Bettiah, India

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.

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Prevalence of inducible clindamycin resistance in clinical isolates of coagulase negative staphylococci at a tertiary care hospital

Annals of Tropical Medicine and Public Health ◽

10.4103/1755-6783.105124 ◽

2012 ◽

Vol 5 (5) ◽

pp. 427 ◽

Cited By ~ 1

Author(s):

Neha Bansal ◽

Uma Chaudhary ◽

Vivek Gupta

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Clinical Isolates ◽

Care Hospital ◽

Coagulase Negative Staphylococci ◽

Inducible Clindamycin Resistance

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INDUCTION OF CLINDAMYCIN RESISTANCE IN CLINICAL ISOLATES OF STAPHYLOCOCCUS AUREUS FROM A TERTIARY CARE HOSPITAL.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i12.1566 ◽

2020 ◽

Vol 4 (12) ◽

Author(s):

Avneet Kaur Heyar ◽

Kamaldeep Kaur ◽

Amarjit Kaur Gill ◽

Prabhjot Kaur Gill

Keyword(s):

Staphylococcus Aureus ◽

Treatment Failure ◽

Rural Areas ◽

Antimicrobial Agents ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Inducible Clindamycin Resistance ◽

Constitutive Resistance ◽

Sensitive Method

Nowadays in Staphylococcus aureus isolates resistant to lincosamide, macrolide and streptogramin B (MLSB) group of antibiotics are expanded. Therefore, clindamycin is preferred drug for the treatment of infections caused by S. aureus, but due to change in sensitivity patterns of clindamycin it is leading to treatment failure. The three resistance phenotypes of MLSB antibiotics are iMLSB (inducible resistance) and cMLSB (constitutive resistance) that are resistant to macrolides, lincosamides and streptogrammins B antibiotics, whereas MS resistance that is sole resistant to macrolides and streptogramins B antibiotics. Erythromycin ribosome methylase (erm) genes are responsible for expressing inducible clindamycin resistance among S. aureus. In the present investigation, a Double disc approximation/Disc induction test (D-test) and PCR were used. Out of 428 strains the prevalence of iMLSB, cMLSB and MS phenotypes were 36 (8.41%), 47 (10.98%) and 48(11.21%) respectively. It is concluded that D-test should be routinely done to avoid treatment failure due to clindamycin resistance. In addition, PCR is a simple, quick, reliable and sensitive method that could also be used in the detection of inducible clindamycin resistance. The reason for the lower prevalence of iMLSB phenotype in the present study could be due to the reason that samples included in this study were mostly from the rural areas as the exposure of antimicrobial agents is less. Keywords: Clindamycin resistance, D-test, ermA, ermC, iMLSB, S. aureus

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