Walailak Journal of Science and Technology (WJST) 
Email this article 
Hide
Show all
Incidence of Constitutive and Inducible Clindamycin Resistance in Clinical Isolates of Methicillin Resistant Staphylococcus aureus
Abstract
Without the double-disk test, all the Staphylococcus aureus isolates with inducible clindamycin resistance would have been misclassified as clindamycin susceptible, resulting in an underestimated clindamycin resistance rate. Clindamycin resistance rates may vary by geographic region and methicillin susceptibility. Hence it should be determined in individual settings. The high frequency of methicillin resistant S. aureus (MRSA) and methicillin susceptible S. aureus (MSSA) isolates with in vitro inducible clindamycin resistance at hospitals raises concern that clindamycin treatment failures may occur with MSSA as well as with MRSA infections. Clinical laboratories should report in vitro inducible clindamycin resistance in S. aureus isolates and clinicians should be aware of the potential of clindamycin treatment failure in patients with infections caused by inducible resistant strains. In this study, the percentage of inducible clindamycin resistance at two hospitals (Maharaj Nakhon Si Thammarat Hospital, Nakhon Si Thammarat, Thailand and Chumphon Khet Udomsak Hospital, Chumphon, Thailand) were 50 (25/50) and 8.3 (1/12) for methicillin resistant Staphylococcus aureus, respectively. Given the data of inducible resistance to clindamycin found in the two hospitals, we conclude that susceptibility testing of staphylococci should include the disk diffusion induction test (D-test) for usefulness of therapeutic treatment of staphylococci infections.
Keywords
References
R Gadepalli, B Dhawan, S Mohanty, A Kapil, BK Das and R Chaudhry. Inducible clindamycin resistance in clinical isolates of Staphylococcus aureus. Indian J. Med. Res. 2006; 123, 571-3.
R Leclercq. Mechanism of resistance to macrolide and lincosamides: nature of the resistance elements and their clinical implications. Clin. Infect. Dis. 2002; 34, 482-92.
JS II Lewis and JH Jorgensen. Inducible clindamycin resistance in Staphylococci: should clinicians and microbiologists be concerned? Clin. Infect. Dis. 2005; 40, 280-5.
J Retsema and W Fu. Macrolides: structures and microbial targets. Int. J. Antimicrob. Agents 2001; 18 (Suppl 1), S3-S10.
E Perez-Roth, F Claverie-Martin, N Batista, A Moreno and S Mendez-Alvarez. Mupirocin resistance in methicillin-resistant Staphylococcus aureus clinical isolates in a Spanish hospital. Co-application method of multiplex PCR assay and conventional microbiology methods. Diag. Microbiol. Infect. Dis. 2002; 43, 123-8.
PC Schreckenberger, E Ilendo and KL Ristow. Incidence of constitutive and inducible resistance in Staphylococcus aureus and coagulase-negative staphylococci in a community and a tertiary care hospital. J. Clin. Microbiol. 2004; 42, 2777-79.
KR Fiebelkorn, SA Crawford, ML McElmeel and JH Jorgensen. Practical disk diffusion method for detection of inducible clindamycin resistance in Staphylococcus aureus and coagulase-negative staphylococci. J. Clin. Microbiol. 2003; 41, 4740-44.
D Drinkovic, ER Fuller, KP Shore, DJ Holland and R Ellis-Pegler. Clindamycin treatment of Staphylococcus aureus expressing inducible clindamycin resistance. J. Antimicrob. Chemother. 2001; 48, 315-6.
JR Bradley. Newer antistaphylococcal agents. Curr. Opin. Pediatr. 2005; 17, 71-7.
CD Steward, PM Reney, AK Morrell, PP Williams, LK McDougal, L Jevitt, JE McGowan, Jr and FC Tenover. Testing for inducible of clindamycin resistance in erythromycin-resistant isolates of Staphylococcus aureus. J. Clin. Microbiol. 2005; 43, 1716-21.
WE Kloos and TL Bannerman. Staphylococcus and Micrococcus spp. In: PR Murrey, EJ Baron, MA Pfaller, FC Tenover and RH Yolken (eds). Manual of Clinical Microbiology. 5th ed. Washington DC: American Society for Microbiology Press, 1995, p. 282-98.
AH Huang, JJ Yan and JJ Wu. Rapid dissemination of Staphylococcus aureus with classic oxacillin resistance phenotype at a new university hospital. J. Hosp. Infect. 2000; 44, 309-15.
Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing 2006; 16th Informational Supplement M100-S16. Wayne, PA: CLSI.
B Weisblum. Insights into erythromycin action from studies of its activity as inducer of resistance. Antimicrob. Agents Chemother. 1995; 39, 797-805.
B Weisblum and V Demohn. Erythromycin-inducible resistance in Staphylococcus aureus: survey of antibiotic classes involved. J. Bacteriol. 1969; 98, 447-52.
F-J Schmitz, J Petridou, AC Fluit, U Hadding, G Peters and C von Eiff. Distribution of macrolide-resistant genes in Staphylococcus aureus blood-culture isolates from fifteen German university hospitals. M.R.S.A Study Group. multicenter study on antibiotic resistance in staphylococci. Eur. J. Clin. Microbiol. Infect. Dis. 2000; 19, 385-7.
AL Frank, JF Marcinak, PD Mangat, JT Tjhio, S Kelkar, PC Schreckenberger and JP Quinn. Clindamycin treatment of methicillin-resistant Staphylococcus aureus infections in children. Pediatr. Infect. Dis. J. 2002; 21, 530-4.
G Martinez-Aquilar, WA Hammerman, EO Mason Jr. and SL Kaplan. Clindamycin treatment of invasive infections caused by community-acquired, methicillin-resistant and methicillin-susceptible Staphylococcus aureus in children. Pediatr. Infect. Dis. J. 2003; 22, 593-8.
GK Siberry, T Tekle, K Carroll and J Dick. Failure of clindamycin treatment of methicillin-resistant Staphylococcus aureus expressing inducible clindamycin resistance in vitro. Clin. Infect. Dis. 2003; 37, 1257-60.
JMT Hamilton-Miller and S Shah. Patterns of phenotypic resistance to the macrolide-lincosamide-ketolide-streptogramin group of antibiotics in staphylococci. J. Antimicrob. Chemother. 2000; 46, 941-9.
WD Jenssen, S Thakker-Varie DT Dubin and MP Weinstein. Prevalence of macrolides-lincosamides-streptogramin B resistance and erm gene classes among clinical strains of staphylococci and streptococci. Antimicrob. Agents Chemother. 1987; 31, 883-8.
FG Nicola, LK McDougal, JW Biddle and FC Tenover. Characterization of erythromycin-resistant isolates of Staphylococcus aureus in the United State from 1958 through 1969. Antimicrob. Agents Chemother. 1998; 42, 3024-27.
S Panagea, JD Perry and FK Gould. Should clindamycin be used as treatment of patients with infections caused by erythromycin-resistant staphylococci? J. Antimicrob. Chemother. 1999; 44, 81-2.
ML Sanchez, KK Flint and RN Jones. Occurrence of macrolide-lincosamide-streptogramin resistances among staphylococcal clinical isolates at a university medical center. Is false susceptibility to new macrolides and clindamycin a contemporary clinical and in vitro testing problem? Diagn. Microbiol. Infect. Dis. 1993; 16, 205-13.
CA Sattler, EO Mason Jr and SL Kaplan. Prospective comparison of risk factors and demographic and clinical characteristics of community-acquired, methicillin-resistant versus methicillin-susceptible Staphylococcus aureus infection in children. Pediatr. Infect. Dis. J. 2002; 21, 910-6.
TP Levin, B Suh, P Axelrod, AL Truant and T Fekete. Potential clindamycin resistance in clindamycin-susceptible, erythromycin-resistant Staphylococcus aureus: report of a clinical failure. Antimicrob. Agents Chemother. 2005; 49, 1222-24.
Refbacks
- There are currently no refbacks.
Print ISSN: 1686-3933
Online ISSN: 2228-835X
http://wjst.wu.ac.th
Last updated: 5 March 2014