TY - JOUR AU - Kishk, Rania Mohammed AU - Anani, Maha Mohammed AU - Nemr, Nader Attia AU - Soliman, Nashaat Mohamed AU - Fouad, Marwa Mohamed PY - 2020/11/30 Y2 - 2024/03/29 TI - Inducible clindamycin resistance in clinical isolates of staphylococcus aureus in Suez Canal University Hospital, Ismailia, Egypt JF - The Journal of Infection in Developing Countries JA - J Infect Dev Ctries VL - 14 IS - 11 SE - Original Articles DO - 10.3855/jidc.12250 UR - https://jidc.org/index.php/journal/article/view/33296341 SP - 1281-1287 AB - <p>Introduction: The increasing incidence of methicillin resistance among <em>Staphylococci</em> has led to renewed interest in the usage of macrolide-lincosamide-streptogramin B (MLSB) antibiotics to treat <em>S. aureus</em> infections, with clindamycin being the preferable agent owing to its excellent pharmacokinetic properties. Inducible clindamycin resistance my lead to therapeutic failure.</p><p>Aim: Detection of the prevalence of constitutive and inducible clindamycin resistance in clinical isolates of <em>S. aureus</em> to improve the clinical outcomes in patients.</p><p>Methodology: A total of 176 non-duplicate staphylococcal isolates were isolated from different clinical samples. Methicillin resistance was detected using Cefoxitin disk diffusion (CDD) method. Phenotypic clindamycin resistance was performed for all isolates by D test. Polymerase Chain Reaction (PCR) assay were done for detection of <em>erm</em> resistance genes <em>(erm</em>A, <em>erm</em>B and <em>erm</em>C).</p><p>Results: Out of 176 strains of <em>S. aureus</em>, 108 isolates (61.3%) were identified as MRSA. Erythromycin and clindamycin resistance was detected in 96 isolates (54.5%) and 68 isolates (38.6%) respectively. Clindamycin resistance (cMLS<sub>B</sub>) was significantly higher (<em>p</em> value &lt; 0.001) in MRSA strains (56 isolates) compared to MSSA (12 isolates). Resistant genes were detected in 160 isolates (91%). The <em>erm</em>A gene was detected in 28 isolates (16%), the <em>erm</em>B gene was detected in 80 isolates (45.5%) (<em>p</em> &lt; 0.001).</p><p>Conclusions and recommendations: The frequency of constitutive and inducible clindamycin resistance in MRSA isolates emphasizes the need to use D test in routine antimicrobial susceptibility testing to detect the susceptibility to clindamycin as the inducible resistance phenotype can inhibit the action of clindamycin and affect the treatment efficacy.</p> ER -