PREVALENCE OF CONSTITUTIVE AND INDUCIBLE CLINDAMYCIN RESISTANCE AMONG CLINICAL ISOLATES OF STAPH AUREUS IN KASHMIR VALLEY: A HOSPITAL BASED STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2016, Vol 5, Issue 17
Abstract
Methicillin resistant Staphylococcus aureus has become endemic in India with the prevalence ranging from 25% in the west India to 50% in south India. Clindamycin therapy is a useful alternative to treatment of such infections. However, bacterial resistance to this drug has been known to occur through various mechanisms with variable prevalence in different geographical regions and among Methicillin Sensitive (MSSA) and Methicillin Resistant Staphylococcus aureus (MRSA). The most common being MLSB (Macrolide, Lincosamide and Streptogramin B) resistance mediated by erm genes. While constitutive MLSB resistance is easily picked up by routine antimicrobial disc diffusion susceptibility tests, the inducible MLSB resistance is only picked up by D zone test. MATERIAL AND METHODS We evaluated 343 clinical isolates of Staphylococcus aureus for MLSB resistance phenotypes using D zone test. Identification of Staphylococcus aureus isolates was done by standard biochemical techniques and then subjected to routine susceptibility testing by Kirby Bauer’s disc diffusion method on Mueller Hinton agar plates. RESULTS All isolates were resistant to penicillin. 61.23% (210) were MRSA and 38.77% (133) were MSSA. Among the MRSA isolates 49.5% and 7.14% isolates showed cMLSB and iMLSB resistance respectively, whereas among 133 MSSA isolates 8.27% and 2.26% isolates showed cMLSB and iMLSB resistance respectively. DISCUSSION The present study revealed a high prevalence of cMLSB in our region. Also prevalence of cMLSB and iMLSB resistance in MRSA is higher than that in the MSSA isolates showing that the distribution of MLSB resistance phenotypes varies among MSSA/MRSA isolates and among different geographical regions. Overall, we found 43.33% clindamycin resistance among MRSA and 10.5% resistance among MSSA isolates. We suggest clindamycin should be used as a therapeutic drug with caution for Staphylococcal infections and recommend that the D zone test should be used as a routine screening procedure to evaluate inducible clindamycin resistance in Staphylococcus aureus to overcome any subsequent treatment failure.
Authors and Affiliations
Shaika , Mehvish
Keywords
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- EP ID EP133633
- DOI 10.14260/jemds/2016/191
- Views 60
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