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Abstract

INDUCIBLE CLINDAMYCIN RESISTANCE IN STAPHYLOCOCCUS AUREUS: A STUDY IN TERTIARY CARE HOSPITAL IN BHOPAL

Mansi Gupta*, Navinchandra M. Kaore, Vijay Kumar Ramnani

ABSTRACT

Introduction: Emergence of increasing resistance in Staphylococcus aureus has renewed the interest in Clindamycin (lincosamide) usage because of its good pharmacokinetic properties in the treatment of Staphylococcal infections especially in Methicillin Resistant Staphylococcus aureus (MRSA) infections. Erythromycin (macrolide) also used to treat Staphylococcal infections but it is a potent inducer of Clindmycin resistance. Combined use of these drugs pose a threat of treatment failure. Phenotypic detection of Erythromycin induced Clindamycin resistance by a simple D- test can be done in clinical laboratories to curb inappropriate use of these drugs in Staphylococcal infections including MRSA strains. Objectives: To find out the burden of Inducible clindamycin resistance & its relation with MRSA. Materials and Methods: A total of 127 clinical isolates of S. aureus between March 2013- July2013 collected from various Clinical samples were processed to routine antimicrobial Suceptibility test using modified Kirby- Bauer disc diffusion method-using Cefoxitin (30 μg) disc to detect MRSA. Erythromycin (15 μg) & Clindamycin (2 μg) disc placed at a distance of 15mm to detect Erythromycin induced Clindamycin resistance by D – test as per CLSI guidelines. Results: Among 127 isolates, 21(16.53%) isolates showed inducible Clindamycin resistance, out of which 13 were MRSA strains. So percentage of inducible Clindamycin resistance was higher in MRSA (61.90%) as compared to MSSA (38.09%). Conclusions: For optimum treatment of patients, D-test which is simple and feasible test should be used as routine lab method to detect inducible Clindamycin resistance in Staphylococci.

Keywords: Inducible Clindamycin resistance, MRSA, D-test.


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