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INDUCIBLE CLINDAMYCIN RESISTANCE AMONG STAPHYLOCOCCUS AUREUS ISOLATES FROM VARIOUS CLINICAL SAMPLES

KAVITHA A V

Abstract


BACKGROUND Increasing frequency of methicillin resistant Staphylococcus aureus (MRSA) infections and changing patterns in antimicrobial resistance have led to  renewed interest in the use of macrolide - lincosamide- streptogramin (MLS) antibiotics to treat such infections. Widespread use of   macrolide- lincosamide- streptogramin (MLS) antibiotics, has led to an increase in a number of staphylococci acquiring    cross-resistance to MLS antibiotics. The most common   mechanism for such resistance is target site modification mediated by erm genes which can be expressed either  constitutively (constitutive MLSB phenotype) or inducibely (inducible MLSB phenotype). Another mechanism of resistance mediated through msr A genes i.e. efflux of antibiotic. This study aims at detecting inducible clindamycin resistance among Staphylococcus aureus isolates collected from various clinical samples by using D test. AIM AND OBJECTIVE To detect the methicillin resistant Staphylococcus aureus. To detect the           inducible clindamycin resistance among Staphylococcus aureus isolates by using D test. MATERIALS AND METHODS                 Staphylococcus aureus were identified by colony characteristics and standard biochemical techniques. Methicillin resistant Staphylococcus aureus was detected using cefoxitin (30micrograms) disc diffusion method as per CLSI 2013              guidelines. Inducible Clindamycin resistance was detected by D test according to CLSI 2013 guidelines. RESULT Out of 489 samples, 200(40.89 percent) were found to be erythromycin resistant. inducible clindamycin resistance (iMLSB phenotype) was observed in 76(15.54 percent), Constitutive resistance (cMLSB phenotype) was seen in 64(13.08 percent), clindamycin sensitive and erythromycin resistance (MS Phenotype) was observed in 60(12.26 percent). Inducible clindamycin resistance (iMLSB phenotype) was higher in MRSA samples 49(18.70 percent) than in MSSA 27(11.89 percent). CONCLUSION It is imperative to detect inducible clindamycin resistance by using D test which should be done routinely in laboratory to guide the clinician for the judicious use of clindamycin and for effective treatment with clindamycin.

 


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