One Year Retrospective Study of Ocular Infection in a Tertiary Care Hospital from Timisoara

2018 ◽  
Vol 69 (10) ◽  
pp. 2910-2912
Author(s):  
Iulia Cristina Bagiu ◽  
Delia Ioana Horhat ◽  
Simona Popescu ◽  
Florin George Horhat ◽  
Ciprian Pilut ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Staphylococcus Epidermidis ◽  
Care Center ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Ocular Infection ◽  
Care Hospital ◽  
Exclusion Criteria ◽  
Ocular Infections ◽  
Department Of Ophthalmology

Eye is the most important sensory organ concerned with the perception of vision. Ocular infections are one of the common diseases of the eye. Ocular infections as blepharitis, conjunctivitis, canaliculitis, dacryocystitis, keratitis, scleritis, orbital cellulitis, endophthalmitis, panophthalmitis and other infections which are responsible for increased incidence of morbidity and blindness worldwide, their morbidity vary from self-limiting trivial infection to sight threatening infection. To identify the bacterial profile of ocular infections in patients attending Ophthalmology Department. After clinical diagnosis of ocular infection made by Ophthalmologist, specimens were collected with the help of Ophthalmologist. Samples like eyelid swab, pus from dacryocystitis, corneal scrapings, corneal swab, and tissue specimens from 189 patients attending Ophthalmology Department were analyzed from 01.01.2014 to 01.01.2015. Using predefined inclusion and exclusion criteria, samples were collected according to the standard protocol. Inclusion criteria: 1. Clinically diagnosed cases of ocular infections attending Outpatient Department and Inpatient Department of Ophthalmology, Tertiary Care Center from Timisoara 2. Patients not on antibiotics (systemic or either topical) will be included in the study. 3. Patients not responding to antibiotics. Exclusion criteria: 1. Non-infectious etiology of ocular diseases. The material was examined Gram staining. The specimens were cultured on sheep�s blood agar, Chocolate agar and MacConkey agar, Chapman agar, Sabouraud dextrose agar. Drug susceptibility was tested using disc diffusion method (Kirby Bauer).The most common bacterial pathogen isolated were Staphylococcus aureus (29.7%) followed by Staphylococcus epidermidis (22.1%), other organisms isolated are Streptococcus pneumonia (17.9%), Klebsiella spp. (6.3%), Escherichia coli (4.7%), Pseudomonas aeruginosa (3.4%). Among the opportunistic pathogens, Staphylococcus epidermidis, (22.1%) were the most common isolate followed by Staphylococcus saprophyticus (0.45%). Bacterial isolates were highly susceptible to Vancomycin (100%), Gentamicin (92.1%) among Gram positive organisms. The Gram negative organisms are highly susceptible to Tobramycin (95.4%) and Imipenem (87.9%). The study suggests that Staphylococcus aureus and Staphylococcus epidermidis are the most common etiological agents of Ocular infections. Most of the strains were sensitive to Vancomycin and Tobramycin. Persistent efforts should be put for continuous surveillance and epidemiological characterization which are imperative to treat and prevent morbidity and blindness of population at risk.

scholarly journals Incidence and Risk Factors of Ocular Infection Caused by Staphylococcus aureus Bacteremia

2016 ◽  
Vol 60 (4) ◽  
pp. 2012-2017 ◽  
Author(s):  
Jiwon Jung ◽  
Junyeop Lee ◽  
Shi Nae Yu ◽  
Yong Kyun Kim ◽  
Ju Young Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Tertiary Care ◽  
Ocular Infection ◽  
Ocular Involvement ◽  
Care Hospital ◽  
Content Type ◽  
Ocular Infections ◽  
Metastatic Infection

ABSTRACTStaphylococcus aureusbacteremia (SAB) often leads to ocular infections, including endophthalmitis and chorioretinitis. However, the incidence, risk factors, and outcomes of ocular infections complicated by SAB are largely unknown. We retrospectively analyzed the incidence and risk factors of ocular involvement in a prospective cohort of patients with SAB at a tertiary-care hospital. Ophthalmologists reviewed the fundoscopic findings and classified the ocular infections as endophthalmitis or chorioretinitis. During the 5-year study period, 1,109 patients had SAB, and data for 612 (55%) who underwent ophthalmic examinations within 14 days after SAB onset were analyzed. Of those 612 patients, 56 (9% [95% confidence interval [CI], 7 to 12%]) had ocular involvement, including 15 (2.5%) with endophthalmitis and 41 (6.7%) with chorioretinitis. In a multivariate analysis, infective endocarditis (adjusted odds ratio [aOR], 5.74 [95% CI, 2.25 to 14.64]) and metastatic infection (aOR, 2.38 [95% CI, 1.29 to 4.39]) were independent risk factors for ocular involvement. Of the 47 patients with ocular involvement who could communicate, only 17 (36%) had visual disturbances. Two-thirds of the patients with endophthalmitis (10/15 patients) were treated with intravitreal antibiotics combined with parenteral antibiotics, whereas all of the patients with chorioretinitis were treated only with systemic antibiotics. No patients became blind. Among 42 patients for whom follow-up assessments were available, the ocular lesions improved in 29 (69%) but remained the same in the others. Ocular involvement was independently associated with death within 30 days after SAB onset. Ocular involvement is not uncommon among patients with SAB. Routine ophthalmic examinations should be considered for patients with infective endocarditis or metastatic infections caused by SAB.

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.

scholarly journals Frequency and Sensitivity Patterns of Staphylococcus Aureus in a Tertiary Care Setting

2021 ◽  
pp. 121-126
Author(s):  
Aneela Khawaja ◽  
Asma Ejaz ◽  
. Abeer ◽  
Faiqa Arshad ◽  
Zaheer Saleem ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Care Setting ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Infection Prevention And Control ◽  
Multiple Infections ◽  
Care Hospital ◽  
Sensitivity Testing ◽  
Tertiary Care Setting

Background: Staphylococcus aureus (SA) is a major etiological pathogen causing multiple infections and broadly known as a serious public health challenge faced due to antibiotic resistance. It is the need of time that infection prevention and control strategies; and antibiotic stewardship policies have to be employed conjointly to minimize the extended rise of antibiotic resistance. Objectives: To determine the frequency and sensitivity patterns of Staphylococcus aureus in tertiary care setting. Study Design: Descriptive study Place & Duration of Study: Pathology Laboratory of tertiary care center from 1st March’ 2020 till 28th February’ 2021. Materials & Methods: A total 643 Staph. aureus isolated from various clinical specimens received in a tertiary care hospital; were processed and identified by culture, staining and bench tests. Sensitivity testing was done by Disc Diffusion method. Resistance to cefoxitin(30µg) was labelled as Methicillin Resistant Staphylococcus aureus (MRSA). Constitutive and Inducible Clindamycin resistance was also evaluated. (CLSI, 2020-21). Results: During the study period 125 (19.44%) MRSA were recovered. Statistically, gender distribution regarding MRSA was significant, most of SA was recovered from blood (53.68%), while 46.31% from pus and wound swabs. The frequency of MRSA from Surgical and allied wards was higher (52.63%) than Medicine and allied wards (47.36%). Sensitivity to vancomycin, linezolid and tigecycline was noted 100% by all the isolates. Sensitivity to clindamycin and Doxycycline was 68.42% and 64.81% respectively; while resistance to erythromycin, ciprofloxacin and trimethoprim/sulfamethoxazole was 73.68%, 60% and 57.89%, respectively. Conclusion: The hazardous infections due to Staphylococcus aureus are worrisome in the present therapeutic scenario. A levelheaded prescription of sensitive antibiotics has to be ensured to minimize the rising frequency of resistant strains of SA.

scholarly journals Aerobacterial Vaginosis among Women Attending an Infertility Clinic at a Tertiary Care Hospital in Chennai, India and Susceptibility Pattern of Isolates

2021 ◽  
Author(s):  
Abigail R. Sopia ◽  
Pushpa Innocent D. Joseph ◽  
M. Kalyani ◽  
B. Ananthi ◽  
Suresh Dhanaraj ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Tamil Nadu ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Protein Synthesis Inhibitors ◽  
Gram Positive ◽  
Gram Negative

Genital infections and subsequent vaginosis diagnosed through high vaginal swab in women is caused due to fungi or bacteria. The presented study focused on determining the types, numbers and antibacterial susceptibility pattern of aerobic bacteria causing vaginosis in 147 female patients attending infertility centre in Chennai, Tamil Nadu, India. Candida spp. caused 17% of infections with 15.7% of vaginosis caused by E.coli, Klebsiella spp., Acinetobacter spp., Citrobacter spp. and Gram positive cocci – Methicillin Sensitive Staphylococcus aureus (MSSA), Coagulase Negative Staphylococci(CONS), Staphylococcus aureus and Enterococcus spp. causing 12.9% of vaginitis in the study population. A total of 20 different antibiotics – cell wall inhibitors, protein synthesis inhibitors and nucleic acid synthesis inhibitors; were tested to determine the response of bacterial isolates by Kirby-Bauer disc diffusion method. The study result determined that the most effective drug for treating Gram positive bacterial vaginitis as per CLSI guidelines based on susceptibility pattern as: Linezolid(100%), Gentamycin(91.6%), Amikacin(87.5%),Erythromycin(79.2%), Co-Trimoxazole(72.2%), Ciprofloxacin(65.6%) and least Chloramphenicol(44.3%). High level gentamycin(83.3%) was found to be effective in treating Enterococci. The descending order of susceptibility of Gram negative aerobacteria causing vaginitis as per CLSI guidelines are: Amikacin(87.5%), Gentamycin(82.5%), Cefoperazone sulbactam (76.3%), Ciprofloxacin(68.5%), Ceftazidime(62.5%) and least Amoxyclav(25%).All Gram negative bacteria tested were susceptible to– Imipenem and Meropenem as well as Chloramphenicol. Ceftriaxone (87.5%) and Nitrofurantoin(72.3%) among other antibiotics was effective against Gram negative bacteria while all Enterobacteriaceae members were found to be resistant to tetracycline.

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 PERFORMANCE OF CHROM AGAR MEDIUM AND CONVENTIONAL METHODS FOR DETECTION OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS.

2016 ◽  
Vol 9 (6) ◽  
pp. 136
Author(s):  
Nilima R Patil
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Care Hospital ◽  
Disc Diffusion ◽  
Disc Diffusion Method ◽  
Methicillin Resistant ◽  
Conventional Methods

Background:- Methicillin resistant Staphylococcus aureus (MRSA) are responsible for hospital and community acquired infections. There are many laboratory methods for detection of MRSA. Chromogenic media have been used for the last few years for the quick detection of MRSA. Objective:- Aim of this study was to compare the performance of   conventional methods and chromogenic media for the detection of MRSA in a tertiary care hospital. Material and method: - 200 consecutive isolates of S. aureus confirmed by conventional methods, collected in a tertiary care hospital were used for this study. Cefoxitin and oxacillin disc diffusion test used as conventional methods and Chromogenic media i.e. oxacillin resistant screen agar base (ORSAB) was used for detection of methicillin resistant Staphylococcus aureus. All confirmed MRSA were checked by gold standard mecA base PCR method. Result: - Out of 200 isolates of Staphylococcus aureus, 50,52 and 47 strains were MRSA by Cefoxitin disc diffusion method, oxacillin disc diffusion method and oxacillin resistant screen agar base (ORSAB)  method respectively. Specificity was 100%, 98.66%, 98.66% by Cefoxitin disc diffusion, oxacillin disc diffusion and ORSAB method respectively. Conclusion: - In conclusion, cefoxitin disc diffusion was the best for the phenotypic detection of MRSA because their sensitivity and specificity were better than oxacillin and ORSAB.

scholarly journals Prevalence and Susceptibility Profiles of Methicillin Sensitive Staphylococcus aureus from Community and Hospital Associated Infections

2021 ◽  
Author(s):  
. Preeja ◽  
Sanath Kumar ◽  
Veena A Shetty
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Tertiary Care ◽  
Control Measures ◽  
Patient Treatment ◽  
Diffusion Method ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
Hospital Associated Infections

Introduction: Methicillin Sensitive Staphylococcus aureus(MSSA) is a significant human pathogen, involved in both hospital and community associated settings. MSSA, being more susceptible to antibiotics compared to Methicillin Resistant Staphylococcus aureus(MRSA), is found to acquire Multidrug Resistance (MDR) and with the presence of virulence factors can pose difficulty in patient treatment. Aim: To study the prevalence and antibiotic resistance profile of MSSA from community and hospital associated infections. Materials and Methods: The present cross-sectional study was conducted in tertiary care hospital in Mangalore, Karnataka, India from January 2015 to February 2017. Three hundred and five Staphylococcus aureuswere isolated from various clinical specimens and tested for methicillin susceptibility using cefoxitin disc. Antibiotic resistance profiles against 23 antibiotics were determined by disc diffusion method. The difference was compared for antibiotic sensitivity with respect to Community Associated Methicillin Sensitive Staphylococcus aureus (CA-MSSA) and Hospital Associated Methicillin Sensitive Staphylococcus aureus (HA-MSSA) and Chi-square test was used for statistical analysis. Results: Of 305 MSSA isolated, 219 (71.8%) were CA-MSSA and 86 (28.2%) were HA-MSSA. S. aureus was isolated mostly from Skin and Soft Tissue Infections (SSTI, 61.3%). Resistance was observed against ciprofloxacin (64.6%), erythromycin (43.9%), ofloxacin (42.3%), clindamycin (20.7%), ampicillin (100%) and penicillin (90.5%). There was a significant difference (p<0.05) between the resistance of CA-MSSA and HA-MSSA against cefotaxime and co-trimoxazole. Conclusion: The present study showed the increasing prevalence of MSSA in the community and hospital settings with the emergence of MDR which has to be dealt immediately with appropriate control measures.

scholarly journals The study of reduced susceptibility of methicillin resistant Staphylococcus aureus to various antibiotics with special reference to glycopeptides in a tertiary care hospital in central India

2019 ◽  
Vol 6 (4) ◽  
pp. 1426
Author(s):  
Swati S. Kale ◽  
Ashwini Patil
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Care Hospital ◽  
Diagnostic Laboratory ◽  
Disk Diffusion Method ◽  
Methicillin Resistant ◽  
Agar Dilution

Background: Staphylococcus aureus has emerged over the past several decades as a leading cause of hospital-associated and community acquired infections. Methicillin resistant S. aureus (MRSA), which are often resistant to several classes of antibiotics, is the most common cause of nosocomial infections and pose a great threat to the world. Vancomycin is regarded as the first-line drug for treatment of MRSA but resistance to this drug is being reported now a day.Methods: It was carried out for a period between January 2014 to June 2017 in the microbiology diagnostic laboratory. MRSA detection was performed by cefoxitin disk diffusion method. Screening for the vancomycin intermediate and the vancomycin resistant S. aureus (VISA and VRSA respectively) was carried out by using vancomycin screen. MIC (minimum inhibitory concentration) of vancomycin was tested by agar dilution method and E strip on all MRSA isolates.Results: A total of 287 S. aureus clinical isolates were included in the study. All MRSA were inoculated on vancomycin screen agar. Visible growth was present in 8 isolates. Five (3.73%) MRSA isolates with MIC of 4 were termed VISA (vancomycin intermediate S. aureus) by agar dilution method. Six isolates had the MIC of 4 and were termed as VISA.Conclusions: As disc diffusion method is not recommended by CLSI for S. aureus, vancomycin screen agar and MIC determination by either of the methods viz. agar dilution or E test can be used.

scholarly journals Antibiogram of Staphylococcus aureus in a Tertiary Care Hospital: Changing Trends

2021 ◽  
Vol 10 (10) ◽  
pp. 319-325
Author(s):  
Priyanka Pradhan Sneha Mohan ◽  
Tarana Sarwat Dalip Kakru
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Care Hospital ◽  
Cross Sectional ◽  
Inducible Clindamycin Resistance ◽  
Healthcare Facilities ◽  
Antimicrobial Susceptibility Pattern

Methicillin resistant Staphylococcus aureus (MRSA) is major cause of nosocomial and community infections. Its prevalence varies with country and with hospitals within a country. Therefore, it is important for continuous surveillance in hospitals and other healthcare facilities in order to limit the spread of infections caused by MRSA. To determine the antibiogram of Staphylococcus aureus in a tertiary care hospital and to determine the change in trends in the antimicrobial susceptibility pattern of Staphylococcus aureus. To determine the prevalence of MRSA in a tertiary care hospital. This cross- sectional study was conducted at the Department of Microbiology, SMSR, Sharda University and Hospital. A total of 100 strains identified by morphological and biochemical characteristics were tested for antibiotic susceptibility using Kirby-Bauer disc diffusion method and the Prevalence of Inducible Clindamycin Resistance among the isolates. 100 out of 13,639 isolates clinical comprising samples were obtained Pus (78.6%), Blood (7%), Swab (4.1%), Sputum (4.1%), Urine (4.1%), Semen (2%). Maximum MRSA were obtained from pus samples (81%). However, out of total 7 isolates of Staphylococcus aureus obtained from blood 4 were MRSA and 3 were MSSA. The prevalence of MRSA that is (40%) infections was a high in our setup and is comparable to studies done earlier. This trend is particularly alarming for Staphylococcus aureus because of the severity and diversity of disease caused by this uniquely versatile pathogen.

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.

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