Abstract
Nowadays in Staphylococcus aureus isolates resistant to lincosamide, macrolide and streptogramin B (MLSB) group of antibiotics are expanded. Therefore, clindamycin is preferred drug for the treatment of infections caused by S. aureus, but due to change in sensitivity patterns of clindamycin it is leading to treatment failure. The three resistance phenotypes of MLSB antibiotics are iMLSB (inducible resistance) and cMLSB (constitutive resistance) that are resistant to macrolides, lincosamides and streptogrammins B antibiotics, whereas MS resistance that is sole resistant to macrolides and streptogramins B antibiotics. Erythromycin ribosome methylase (erm) genes are responsible for expressing inducible clindamycin resistance among S. aureus. In the present investigation, a Double disc approximation/Disc induction test (D-test) and PCR were used. Out of 428 strains the prevalence of iMLSB, cMLSB and MS phenotypes were 36 (8.41%), 47 (10.98%) and 48(11.21%) respectively. It is concluded that D-test should be routinely done to avoid treatment failure due to clindamycin resistance. In addition, PCR is a simple, quick, reliable and sensitive method that could also be used in the detection of inducible clindamycin resistance. The reason for the lower prevalence of iMLSB phenotype in the present study could be due to the reason that samples included in this study were mostly from the rural areas as the exposure of antimicrobial agents is less. Keywords: Clindamycin resistance, D-test, ermA, ermC, iMLSB, S. aureus
Highlights
Staphylococcus aureus causes serious and life threatening clinical infections considered as most important pathogen.[1]
The macrolides, lincosamides and streptogrammins B antibiotics are structurally unrelated but have a same mechanism of action, as the protein synthesis is hampered by binding to 50S ribosomal subunit 23S rRNA.[4]
Based on age of patients, it was observed that maximum number of isolation of S. aureus was among age group 2140 years i.e. 177 (41.36%) and least among patients of age more than 80 years (3) 0.70%
Summary
Staphylococcus aureus causes serious and life threatening clinical infections considered as most important pathogen.[1] The emergence of resistance among S. aureus is an increasing problem nowadays, especially against methicillin.[2] Methicillin resistant S. aureus (MRSA) is of great concern as it is resistant to methicillin but resistant to many other chemotherapeutic agents.[3] for the treatment of MRSA a renewed interest in macrolides, lincosamides and streptogrammins B (MLSB) antibiotics therapy. Clindamycin has fine bioavailability with high oral absorption and used as outpatient therapy and as follow-up therapy after intravenous administration. It has elevated tissue penetration and activity, other than in CNS. It could be used to treat skin and soft tissue infections caused by MRSA.[4,5] there has been an increase in number of MLSB resistant S. aureus strains due to inappropriate and excessive utilization of MLSB group of antibiotics.[2]
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