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  Table of Contents  
CORRESPONDENCE
Year : 2015  |  Volume : 33  |  Issue : 2  |  Page : 327-328
 

Prevalence of inducible clindamycin resistance among Staphylococcal isolates in a tertiary care hospital in North India


Department of Microbiology, Christian Medical College and Hospital, Ludhiana, Punjab, India

Date of Submission16-Apr-2014
Date of Acceptance03-Jul-2014
Date of Web Publication10-Apr-2015

Correspondence Address:
A Oberoi
Department of Microbiology, Christian Medical College and Hospital, Ludhiana, Punjab
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.153576

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How to cite this article:
Tyagi S, Oberoi A. Prevalence of inducible clindamycin resistance among Staphylococcal isolates in a tertiary care hospital in North India. Indian J Med Microbiol 2015;33:327-8

How to cite this URL:
Tyagi S, Oberoi A. Prevalence of inducible clindamycin resistance among Staphylococcal isolates in a tertiary care hospital in North India. Indian J Med Microbiol [serial online] 2015 [cited 2019 Nov 18];33:327-8. Available from: http://www.ijmm.org/text.asp?2015/33/2/327/153576


Dear Editor,

This is regarding one article by Aleksandra AD, Misic MS, Violeta NM, Dragana IT, Zoran BM, Dejan VS, Milanko SD, Dejan BD 'Prevalence of inducible clindamycin resistance among community-associated Staphylococcal isolates in central Serbia' 2014;32:49-52 [1] published in the Indian Journal of Medical Microbiology. In this article, the authors prospectively analyzed 482 community-associated Staphylococcal isolates, of which 395 were Staphylococcus aureus and 87 were coagulase-negative Staphylococcus species. They performed their susceptibility testing by standard disk diffusion method according to CLSI standards. [2] All erythromycin-resistant clindamycin susceptible isolates were further tested for inducible clindamycin resistance with D test. [3] Following this, phenotypic categorization was done into MS B phenotype, iMLS B (inducible clindamycin resistance) resistance phenotype and cMLS B (constitutive clindamycin resistance) resistance phenotype, where MS B phenotype demonstrated a circular clindamycin zone, iMLS B resistance phenotype isolates demonstrated flattening of the clindamycin zone and cMLS B resistance phenotype isolates showed resistance to both erythromycin and clindamycin. Considering the results of their analysis on only the S. aureus isolates in their study, findings were that out of 395 S. aureus isolates, 129 (32.66%) were resistant to erythromycin, of which 24% (n = 31) showed MS B phenotype, 50% (n = 64) iMLS B resistance phenotype and 26% (n = 34) showed cMLS B resistance phenotype. We also did a similar study in a tertiary care hospital in North India where we analyzed 750 S. aureus isolates from different clinical samples received in the microbiology laboratory over a period of 6 months. With similar material and methods, phenotypic detection of MS B phenotype, iMLS B resistance phenotype and cMLS B resistance phenotype was performed. Our results showed some differences in the prevalence of these phenotypes in our isolates from the above mentioned study. Out of 750 S. aureus isolates, 441 (58.8%) were resistant to erythromycin, of which 20.13% (n = 151) showed MS B phenotype, 20.27% (n = 152) iMLS B resistance phenotype and 18.40% (n = 138) showed cMLS B resistance phenotype. The prevalence of MS B phenotype and cMLS B resistance phenotype in both the studies are nearly same; however, there is a marked difference between the prevalence of iMLS B resistance phenotype in the two studies. This difference may be due to the different geography and varying epidemiological factors or may be due the origin of isolates, which were solely community associated in their study as compared to our study, which might be of hospital or community origin. Hence, periodic surveillance is necessary for determination of the prevailing phenotypes in different geographical regions to direct the antibiotic guidelines accordingly.

 
 ~ References Top

1.
Aleksandra AD, Misic MS, Violeta NM, Dragana IT, Zoran BM, Dejan VS, et al. Prevalence of inducible clindamycin resistance among community-associated staphylococcal isolates in central Serbia. Indian J Med Microbiol 2014;32:49-52.  Back to cited text no. 1
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2.
Clinical Laboratory Standards Institute (CLSI) guidelines. Performance standards for antimicrobial susceptibility testing: Nineteenth informational supplement. CLSI Document M100-S19. Clinical and Laboratory Standards institute. Pennsylvania: Wayne; 2009. p. 59  Back to cited text no. 2
    
3.
Woods CR. Macrolide inducible resistance to clindamycin and D-test. Pediatr Infect Dis J 2009;28:1115-8.  Back to cited text no. 3
    




 

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