Characterization and Prevalence of Clindamycin Resistance Staphylococcus aureus from Clinical samples of National Medical College and Teaching Hospital, Nepal
Objective: Clindamycin is the drug of choice for the treatment of severe form of skin, soft tissue, and blood infections caused by resistant Staphylococcus aureus in the form of methicillin-resistant S. aureus (MRSA) and erythromycin-resistant S. aureus. In this research, we determine the susceptibility pattern of isolated S. aureus strains against antibiotics and the prevalence of resistant S. aureus in the form of MRSA, inducible clindamycin-resistant S. aureus (inducible macrolide-lincosamide-streptogramin B [iMLSB]) and constitutive clindamycin-resistant S. aureus (cMLSB).
Methods: A total of 310 isolated S. aureus among 2000 different clinical samples were subjected to oxacillin (1 μg) as per the Kirby-Bauer disk diffusion method for MRSA. Clindamycin-resistant either in the form of iMLSB or cMLSB was determined through double disk diffusion method or D-test by use erythromycin (2 μg) and clindamycin (15 μg) as per the CLSI guidelines.
Results: Out of total S. aureus, MRSA and methicillin-sensitive S. aureus (MSSA) were 78.06% and 20.64%, respectively. This study showed that iMLSB and cMLSB were 34.19% and 23.22%. Both iMLSB and cMLSB were found more among MRSA than MSSA (43.80%, 26.85% and 40.62%, 10.93%), respectively.
Conclusion: This study helps for the characterization of different resistant strains of S. aureus along with the determination of the prevalence rate of these mutant forms causing nosocomial infections.
2. DeLeo FR, Chambers HF. Reemergence of antibiotic-resistant Staphylococcus aureus in the genomics era. J Clin Invest 2009;119:2464-74.
3. Bhoosan M, Prasad J, Dutta A, Ke V, Mukhopadhyan C. Reduced susceptibility of MRSA to vancomycin. Int J Pharm Pharm Sci 2016;8:321-2.
4. Patel M, Waites KB, Moser SA, Cloud GA, Hoesley CJ. Prevalence of inducible clindamycin resistance among community and hospital-associated Staphylococcus aureus isolates. J Clin Microbiol 2006;44:2481-4.
5. Lertcanawanichakul M, Chawawisit K, Choopan A, Nakbud K, Dawveerakul K. Incidence of constitutive and inducible clindamycin resistance in clinical isolates of methicillin resistant Staphylococcus aureus. Walailak J Sci Tech 2007;4:155-63.
6. Fiebelkorn KR, Crawford SA, McElmeel ML, Jorgensen JH. Practical disc diffusion method for detection of inducible clindamycin resistance in Staphylococcus aureus and coagulase negative staphylococci. J Clin Microbiol 2003;41:4740-4.
7. Delialioglu N, Aslan G, Ozturk C, Baki V, Sen S. Inducible clindamycin resistance in staphylococci isolated from clinical samples. J Infect Dis 2005;58:104-6.
8. Leclercq R. Mechanisms of resistance to macrolides and lincosamides. Clin Infect Dis 2002;34:482-92.
9. Fiebelkorn KR, Crawford SA, McElmeel ML, Jorgensen JH. Practical disc diffusion method for detection of inducible clindamycin resistance in Staphylococcus aureus and coagulase-negative staphylococci. J Clin Microbiol 2003;41:4740-4.
10. CLSI. Performance Standards for Antimicrobial Susceptibility Testing. Wayne, PA: Clinical and Laboratory Standards Institute; 2007.
11. Miller JM, Shah S. Patterns of phenotypic resistance to the macrolide-lincosamide-ketolide-streptogramin group of antibiotics in staphylococci. J Antimicrob Chemother 2000;46:941-9.
12. Bhatt CP, Karki BM, Baral B, Gautam S, Shah A, Chaudhary A. Antibiotic susceptibility pattern of Staphylococcus aureus and methicillin-resistant Staphylococcus aureus in a tertiary care hospital. J. Pathol. Nepal 2014;4:548-551.
13. Majumder D, Bordoloi JN, Phukan AC, Mahanta J. Antimicrobial susceptibility pattern among methicillin resistant Staphylococcus isolates in Assam. IJMM 2001;19:138-140.
14. Gurdal Y, Kemalettin A. Detection and prevalence of inducible clindamycin resistance in staphylococci. J Med Microbiol 2007;56:342-5.
15. Ravisekhar G, Benu D, Srujana M, Arti K. Inducible clindamycin resistance in clinical isolates of Staphylococcus aureus. Indian J Med Res 2006;123:571-3.
16. Yilmaz G, Aydin K, Iskender S, Caylan R, Koksal I. Dete0ction and prevalence of inducible clindamycin resistance in staphylococci. J Med Microbiol 2007;56:342-5.
17. Rahabar M, Hajia M. Inducible clindamycin resistance in Staphylococcus aureus: A cross sectional report. Pak J Biol Sci 2007;10:189-92.
18. Goyal R, Singh NP, Manchanda V, Mathur M. Detection of clindamycin susceptibility in macrolide resistant phenotypes of Staphylococcus aureus. Indian J Med Microbiol, 2004; 22: 251-254.
19. Levin TP, Suh B, Axelrod P, Truant AL, Fekete T. Potential clindamycin resistance in clindamycin susceptible, erythromycin resistant Staphylococcus aureus: Report a clinical failure. Antimicrob Agents Chemother 2005;49:1222-4.
20. Siberry GK, Tekle T, Carroll K, Dick J. Failure of clindamycin treatment of methicillin resistant Staphylococcus aureus expressing inducible clindamycin resistance in vitro. Clin Infect Dis 2003;37:1257-60.
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.