scholarly journals Inducible Clindamycin Resistance in Staphylococcus aureus Isolated from Clinical Samples

2011 ◽  
Vol 3 (01) ◽  
pp. 025-027 ◽  
Author(s):  
Kavitha Prabhu ◽  
Sunil Rao ◽  
Venkatakrishna Rao
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Agents ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Disc Diffusion ◽  
Gene Encoding ◽  
Inducible Clindamycin Resistance ◽  
Inducible Resistance ◽  
Constitutive Resistance

ABSTRACT Introduction: The resistance to antimicrobial agents among Staphylococci is an increasing problem. This has led to renewed interest in the usage of Macrolide-Lincosamide-Streptogramin B (MLS B ) antibiotics to treat Staphylococcus aureus (S. aureus) infections. The resistance to macrolide can be mediated by msr A gene coding for efflux mechanism or via erm gene encoding for enzymes that confer inducible or constitutive resistance to MLS B antibiotics. In vitro routine tests for clindamycin susceptibility may fail to detect inducible clindamycin resistance due to erm genes resulting in treatment failure, thus necessitating the need to detect such resistance by a simple D test on a routine basis. Materials and Methods : One hundred and ninety S. aureus isolates were subjected to routine antibiotic susceptibility testing including oxacillin (1 µg) and cefoxitin (30 µg) by modified Kirby Bauer disc diffusion method. Inducible resistance to clindamycin in S. aureus was tested by ′D test′ as per CLSI guidelines. Results: Twenty (10%) isolates showed inducible clindamycin resistance, 18 (9%) showed constitutive resistance while remaining 16 (8%) showed MS phenotype. Inducible resistance and constitutive resistance were found to be higher in MRSA as compared to MSSA (20%, 16% and 6%, 6%, respectively). Conclusion : Clindamycin is kept as a reserve drug and is usually advocated in severe MRSA infections depending upon the antimicrobial susceptibility results. This study showed that D test should be used as a mandatory method in routine disc diffusion testing to detect inducible clindamycin resistance in Staphylococci for the optimum treatment of patients.

scholarly journals Phenotypic study of Macrolide-Lincosamide-Streptogramin B Resistance in Staphylococcus aureus and their relationship with Methicillin-Resistant Staphylococcus aureus (MRSA) at Tertiary Care in Eastern Nepal

2016 ◽  
Vol 5 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Ganesh Kumar Singh ◽  
Bigu Kumar Chaudhari ◽  
Kamal Prasad Parajuli
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Agents ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance ◽  
Constitutive Resistance ◽  
Antibiotic Susceptibility Test

Background Resistance to antimicrobial agents is prevalent among Staphylococci. This has led to wide uses of macrolide-lincosamide-streptogramin B (MLSB) antibiotics to Staphylococcus aureus (S. aureus) infections. MLSB though chemically distinct, have similar target site and mode of action. The multiple mechanisms are responsible for resistance to MLSB antibiotics which can lead to clinical failure. The aim of the study was to investigate the frequency of inducible and constitutive clindamycin resistance among clinical isolates of S. aureus and their relationship with Methicillin-resistant Staphylococcus aureus (MRSA).Material & Methods A total of 336 unique Staphylococcus aureus isolates from different clinical samples obtained from patients were studied. Antibiotic susceptibility test was performed by Kirby- Bauer disc diffusion method. “D test” was performed to detect inducible clindamycin resistance as per CLSI guidelines. MRSA was detected using Cefoxitin (30μg) and results were interpreted according to CLSI criteria.Results Inducible clindamycin resistance was seen in 45 (13.39%), constitutive clindamycin resistance was seen among 58 (17.26%) while MS phenotype was observed among 38(11.30%) of isolates. Inducible resistance as well as constitutive resistance was higher among MRSA as compared to MSSA (21.11%, 4.48% and 21.11%, 12.82%respectively).Conclusion The Successful use of clindamycin for the treatment of infection caused by S. aureus can be predicted based on the result of simple and inexpensive D test.Journal of Nobel Medical CollegeVolume 5, Number 1, Issue 8, January-July 2016, 1-5

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

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

scholarly journals IN VITRO ASSESSMENT OF ANTIBACTERIAL ACTIVITY OF STEM AND ROOT OF RAUWOLFIA SERPENTINA AGAINST DIFFERENT BACTERIA

2021 ◽  
Vol 12 (6) ◽  
pp. 87-90
Author(s):  
Virendra Vaishnav ◽  
Debasish Sahoo ◽  
Tanushree Chatterjee
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibacterial Activity ◽  
Antimicrobial Agents ◽  
Development Program ◽  
Positive Control ◽  
Diffusion Method ◽  
Disc Diffusion ◽  
Disc Diffusion Method ◽  
Rauwolfia Serpentina

Medicinal Plants are the good source of natural antimicrobial agents. The main aim of present study was to evaluate the antibacterial activity of stem and root of Rauwolfia serpentina against six microorganism, Powdered stem and root of plant were extracted with acetone, chloroform and methanol and streptomycin used as positive control. The antibacterial activity of Rauwolfia serpentine was detected by using disc diffusion method and agar well diffusion method on the following bacteria- Bacillus cereus, Staphylococcus aureus, Bacillus fusiformis, Escherichia coli, Pseudomonas aeruginosa and P. luminescens. The experiment reported that R. serpentina Root methanol extract shown 14.86 ± 1.11 highest antibacterial activity against Pseudomonas aeruginosa through well diffusion method. Whereas root chloroform recorded 13.46 ± 1.28 highest antibacterial activity against E. coli through disc diffusion method, maximum zone of inhibition 22.66±0.52 mm was found for the positive control, streptomycin through well diffusion method. Further studies should be undertaken to reveal the correct mechanism of action of antimicrobial effect to identify the active ingredients which can be used in drug development program.

TRIALS OF THE DOMESTICALLY PRODUCED NUTRIENT MEDIUM «AGAR MULLER-HINTON II - OBOLENSK»

2019 ◽  
Vol 64 (6) ◽  
pp. 360-367
Author(s):  
I. S. Kosilova ◽  
L. V. Domotenko ◽  
N. K. Fursova ◽  
S. V. Dentovskaya ◽  
M. G. Ershova ◽  
...  
Keyword(s):  
Nutrient Medium ◽  
Antimicrobial Agents ◽  
Clinical Laboratory ◽  
Import Substitution ◽  
Enterobacter Aerogenes ◽  
Diffusion Method ◽  
Disc Diffusion ◽  
Bacterial Strains ◽  
Disc Diffusion Method

The results of the comparative tests of the «Agar Muller-Hinton II - Obolensk» nutrient medium developed in SRCAMB, Obolensk, and the control nutrient medium imported «Mueller Hinton II Agar» are presented in the study. The susceptibility of bacterial clinical strains to antimicrobial agents (AMP) was determined by the disc diffusion method and the method of gradient diffusion (E-test). The carbapenemase activity of the strains carrying the carbapenemase genes was determined by CIM-test. Total 173 characterized bacterial strains of species Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Proteus mirabilis, Serratia marcescens, Enterobacter aerogenes, Escherichia coli; Photorhabdus spp., Staphylococcus aureus, Enterococcus spp. were used in the study, including producers of OXA- and NDM-types carbapenemases for gram negative bacteria. A high degree of coincidence of the results obtained on both nutrient media was shown. The consistency index of the strain sensitivity categories to AMPs (S, I, and R) was 98.2% for the disc diffusion method, and 94.4-100% - for E-test and CIM-test methods. Thus, within the framework of the Import Substitution Program, the domestic nutrient medium «MHA II-Obolensk» has been successfully developed. The nutrient medium meets the requirements of GOST R ISO 20776-2-2010 «Clinical laboratory testing and in vitro diagnostic test systems - Susceptibility testing of infectious agents and evaluation of performance of antimicrobial susceptibility test devices».

scholarly journals Inducible clindamycin resistance among staphylococci isolated from clinical samples in an urban hospital of Dhaka City

1970 ◽  
Vol 5 (1) ◽  
pp. 6-8
Author(s):  
Shameem Akhter ◽  
SM Zahurul Haque ◽  
M Mushfequr Rahman
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care ◽  
Clinical Samples ◽  
Care Hospital ◽  
Urban Hospital ◽  
Inducible Clindamycin Resistance ◽  
Inducible Resistance ◽  
Mueller Hinton ◽  
Mueller Hinton Agar ◽  
Resistant Strains

Inducible clindamycin resistance was detemined in 200 clinical isolates of staphylococci from pus (53.5%) and wound swab (46.5%). The study was done from July 2009 to June 2010, in the Department of Microbiology, BIHS Hospital Dhaka. Inducible clindamycin resistance was demonstrated by placing an erythromycin disc (15 ìg) 15 mm apart from the edge of a clindamycin (2 ìg) disc in Mueller Hinton agar. When the clindamycin inhibited zone becomes D- shaped the organism was regarded as positive for inducible resistance (D- test positive). Out of 200 staphylococci, 20% had inducible clindamycin resistance, 5% had constitutive clindamycin resistance and remaining 75% was clindamycin sensitive. In case of methicillin resistant Staphylococcus aureus (MRSA), 48% had inducible clindamycin resistance while 11.5% was constitutively resistant to clindamycin and remainder were clindamycin sensitive. All clindamycin resistant strains were 100% sensitive to vancomycin and linezolid followed by gentamycin (42%) and tetracycline (42.3%). The findings demonstrated that a substantial proportion of staphylococci in our tertiary care hospital had inducible resistance to clindamycin.Ibrahim Med. Coll. J. 2011; 5(1): 6-8 Key words: Staphylococcus aureus; Inducible clindamycin resistance; Constitutive clindamycin resistance; D-testDOI: http://dx.doi.org/10.3329/imcj.v5i1.9853  

scholarly journals In-Vitro Antibacterial Activity of crude Garlic (Allium Sativum) Extract Against Clinical Isolates of Methicillin Resistant Staphylococcus aureus

2021 ◽  
Vol 14 (3) ◽  
pp. 1449-1457
Author(s):  
Salma Osman Noorelhuda Mohammed ◽  
Nadir Musa Khalil Abuzeid ◽  
Sara Abdelghani ◽  
Lienda Bashier Eltayeb
Keyword(s):  
Staphylococcus Aureus ◽  
Allium Sativum ◽  
Antimicrobial Agents ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Negative Consequences ◽  
Methicillin Resistant ◽  
And Staphylococcus Aureus

Background:Methicillin-resistant Staphylococcus aureus (MRSA) has gained significant health solicitude globallydue to its resistance to nearly almost antimicrobial agents, and garlic is one of nature's most powerful antibiotics that must be used as a pharmaceutical regimen. The current study aimed to determine the In-Vitro antibacterial efficacy of crude garlic extract against MRSA. Methods: The aqueous and 70% ethanol crude garlic (Alllium sativum)extract was prepared. Disc diffusion method was performed to assess the antimicrobial activity for100 clinical isolates of MRSA collected,The reference standard strain was Staphylococcus aureus (ATCC 25923). Results: All MRSA strains assessed were significantly sensitive to 70% ethanolic extract at various concentrations range from 200 to 25%, exhibited inhibitory effects against clinical isolates and Staphylococcus aureus (ATCC 25923) with the means of inhibition zones ranging from 17.76- 14.35 mm and 15-13 mm in length, while the aqueous extracts were less in both clinical isolates and Staphylococcus aureus (ATCC 25923) ranging from 11.93-8.62 mm and 11-8 mm respectively, methanol and distilled water were not effected on growth. Conclusion: The findings demonstrate that 70%ethanol extract of crude Allium sativum has significantly inhibitory effect on methicillin-resistant Staphylococcus aureus is better than aqueous extract. This study does not undermine the value of antibiotic use, but instead the probability of using them in low dosage to minimize their negative consequences.

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 Arising Prevalence of OXA-48 producer Escherichia coli and OXA-48 with NDM co-producer Klebsiella pneumoniae Strains

2019 ◽  
Vol 27 (3) ◽  
pp. 319-326 ◽  
Author(s):  
Aylin Uskudar-Guclu ◽  
Mustafa Guney ◽  
Ali Korhan Sig ◽  
Selcuk Kilic ◽  
Mehmet Baysallar
Keyword(s):  
Antimicrobial Agents ◽  
Carbapenem Resistance ◽  
Resistance Mechanisms ◽  
Resistant Isolate ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Disc Diffusion ◽  
E Coli ◽  
Carbapenem Resistant ◽  
Resistance Rates

Abstract Background/aim: This prospective study aimed to determine the presence of the most common carbapenemase genes, blaOXA-48, blaKPC, blaIMP, blaVIM and blaNDM on carbapenem resistant clinical K.pneumoniae and E.coli isolates. Materials and methods: Isolates were selected according to EUCAST guideline; gradient test and disc diffusion with both meropenem and ertapenem discs. Resistance rates of these isolates to other antimicrobial agents were also examined by disc diffusion method. Carbapenem resistance gene were investigated by using Real-Time PCR. Results: A total of 3845 E. coli and 1689 K.pneumoniae isolates from clinical samples between January 2015 and April 2017 were evaluated. The 419 isolates were found as carbapenem resistant but only the first resistant isolate (n=155; 126 K.pneumoniae and 29 E.coli) of each patient were included. Carbapenem resistant isolates were most frequently isolated from intensive care units (48.8%). Colistin was the most effective antibiotic (91.0%). The 121 (78.1%) of the tested isolates were positive for OXA-48 (103 K.pneumoniae and 18 E.coli) and 9 K. pneumoniae carrying blaNDM were also positive for blaOXA-48. VIM, IMP and KPC type carbapenemases were not detected in any isolates. Conclusion: Carbapenem-resistant pathogens have been shown to be able to develop resistance mechanisms with more than one carbapenemase encoding gene.

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