Anatomical approach to the Liver mobilization A study on cadaveric livers (2025)

Incidence of Constitutive and Inducible Clindamycin Resistance in Staphylococcus aureus and Coagulase-Negative Staphylococci in a Community and a Tertiary Care Hospital

Journal of Clinical Microbiology, 2004

The incidences of inducible clindamycin resistance at two hospitals (an inner-city hospital and a suburban community hospital) were 7 and 12% for methicillin-resistant Staphylococcus aureus , 20 and 19% for methicillin-susceptible S . aureus , and 14 and 35% for coagulase-negative staphylococci, respectively. Given the variability of inducible resistance to clindamycin found in our two hospitals, we conclude that susceptibility testing of staphylococci should include the disk diffusion induction test (D-test).

Evaluation of Prevalence of Inducible Clindamycin Resistance among Coagulase Negative Staphylococci (CoNS) Isolated from Various Clinical Samples in a Tertiary Care Hospital of North India

International Journal of Current Microbiology and Applied Sciences, 2018

Coagulase-negative Staphylococci (CoNS), which are the normal skin flora, have emerged as predominant pathogens in nosocomial as well as community acquired infections (Kloos and Bannerman, 1994; Roopa and Biradar, 2015). Risk factors include patients with intravascular catheters or prosthetic devices. These bacteria usually infect immune compromised hosts, such as premature newborns and patients with leukemia or other malignant diseases (Sheikh and Mehdinejad, 2012). CoNS species have been documented

Use of the D test method to detect inducible clindamycin resistance in coagulase negative staphylococci (CoNS)

Brazilian Journal of Infectious Diseases, 2007

According to the National Committee for Clinical Laboratory Standards (NCCLS, 2004), a method to evaluate the inducible clindamycin resistance in accordance with an approach of the disks of erythromycin and clindamycin – the D test – has been reported. We analyzed the performance of this method in 200 coagulase negative staphylococci (CoNS) strains obtained from blood cultures of hospitalized patients at a general hospital in Southern Brazil. Twenty-seven clinical isolates with suitable profile (erythromycin-resistant and clindamycin-susceptible) were evaluated for the D test realization. Thus, only 5 CoNS were D test positive. The D test method showed to be simple and an important technique in the detection of inducible clindamycin resistance.

Constitutive and Inducible Clindamycin Resistance Frequencies among Staphylococcus sp. Coagulase Negative Isolates in Al-Basrah Governorate, Iraq

Reports of Biochemistry and Molecular Biology

Background: Antibiotics called macrolide, lincosamide and streptogramin B (MLSB) are being used to treat staphylococci infections. Multiple pathways that impart resistance to MLSB antibiotics have been confirmed to cause clinical failure. The present work aimed to determine the frequency of constitutive and inducible clindamycin resistant among coagulase-negative staphylococci (CoNS) isolates of different clinical samples in Al-Basrah governorate, Iraq. Methods: The 28 CoNS, traditional techniques and the Vitek®2 system were used to identify the isolates. The disk diffusion technique was used to detect methicillin resistance and antibiotic sensitivity patterns via cefoxitin, gentamicin, ciprofloxacin, amikacin, teicoplanin, linezolid, doxycycline and vancomycin disks. Erythromycin and clindamycin antibiotic disks was used to detect the inducible and constitutive clindamycin resistance as well as a D-test according to CLSI guidelines. Results: Among 28 CoNS isolated, the Staphylococcus aureus 11(39.29%), Staphylococcus epidermidis 7(25 %), Staphylococcus haemolyticus 4(14.29%) and Staphylococcus saprophyticus 3 (10.71%) were predominant isolated species. Out of 28 CoNS isolates, 15(53.57%) were methicillin resistant coagulasenegative staphylococci (MRCoNS) isolates and 13(46.43%) were methicillin sensitive coagulase-negative staphylococci (MSCoNS) isolates. The 15(53.57%) isolates out of 28 CoNS, showed erythromycin resistance while 6(40%) isolates out of 15 CoNS, showed inducible macrolide-lincosamide-streptogramin B (iMLSB) and 2(13.3%) of CONS isolated showed constitutive macrolide-lincosamide-streptogramin B (cMLSB). Conclusions: In order to achive the best result in choosing the suitable treatment and avoiding the loses the money and time, it is better to use the D-test for inducible clindamycin resistance in the daily routine work of antibiotic susceptibility testing in hospital and private clinical laboratories.

The Prevalence of Inducible Clindamycin Resistance Among Staphylococci in a Tertiary Care Hospital – A Study from the Garhwal Hills of Uttarakhand, India

Objective: This study was undertaken to assess the frequency of the phenotypic expression of the inducible resistance to clindamycin which was due to the expression of the erm genes in various clinical isolates of the Staphylococcus species. Materials and Methods: This was a cross sectional study conducted in the Dept. of Microbiology and Immunology, Veer Chandra Singh Garhwali Govt. Medical Sciences and Research Institute, Srikot, Uttarakhand, from July 2010 to December 2011. A total of 373 consecutive, non duplicate strains of Staphylococci isolated from various clinical samples like pus, wound swab, blood, urine and other body uids, were tested. The isolates which had a discordant resistance pattern (clindamycin-sensitive and erythromycin-resistant) by Kirby Bauer Disk Diffusion method were selected and subjected to the D-test for inducible clindamycin resistance, as per the Clinical and Laboratory Standards Institutes (CLSI) guidelines. Results: Amongthe373clinicalisolatesofStaphylococciwhich were studied, 134 isolates showed a discordant resistance pat- tern. Among these discordant strains, 45 (33.6%) isolates were D-test positive, which had inducible clindamycin resistance and belonged to the inducible macrolide lincosamide strepto- gramin-B phenotype (MLSBi). 89 (66.4%) isolates were D-test negative and they belonged to the macrolide streptogramin phenotype (MS). Among the MLSBi phenotypes, 6 (13.3%) iso- lates were methicillin-resistant Staphylococcus aureus (MRSA), 13 (28.9%) were Methicillin-sensitive S.aureus (MSSA) and 26 (57.8%) were coagulase negative staphylococci (CONS). Conclusion: The D-test is a simple, effective and an important method for the phenotypic detection of inducible clindamycin resistance and it should be used routinely, as it will help in guiding the empirical therapy. The possible clinical failures can thus be avoided.

Prevalence of Inducible Clindamycin Resistance of Staphylococcus aureus in Hospitalized Patients in Tertiary Care Hospital

International journal of current research and review, 2017

Background: Methicillin resistant Staphylococcus aureus (MRSA) has emerged as one of the most common pathogen isolated from patients with very few drugs available for their treatment. Clindamycin is a good alternative optional drug for the treatment of these infections. In vitro routine testing may fail to detect such resistance. Thus it is important to detect such resistance by simple D test. Material and Methods: 300 staphylococcal isolates where isolated from clinical samples by conventional microbiological methods. Of these 208(69.33%) were identified as Staphylococcus aureus. Methicillin resistance and inducible clindamycin resistance was detected by cefoxitin disk diffusion method and D test as per CLSI guidelines respectively. Results: 135 (64.9%) were MRSA and 73 (35.09%) were Methicillin sensitive Staphylococcus aureus (MSSA), 45(21.63%) isolates showed inducible clindamycin resistance, 19(9.1%) showed constitutive clindamycin resistance, 112(53.84%) showed MS phenotype whe...

Detection of Inducible Clindamycin Resistance in Staphylococci by Disk Diffusion Induction Test

Background: Inducible clindamycin resistance is a major concern for the use of clindamycin to treat staphylococcal infections. Aims: To determine the prevalence of inducible clindamycin resistance in clinical isolates of Staphylococcus spp. and the susceptibility pattern of the isolates. Materials and Methods: A total of 300 isolates of Staphylococci spp. recovered from different clinical specimens were studied. All the Staphylococcus spp. were identified by conventional microbiological methods. Inducible clindamycin resistance was detected by double disk approximation test (D-test).Results: Of the 300 isolates, 176 were identified as S. aureus, while 124 were coagulase negative staphylococci (CoNS). The rates of inducible clindamycin resistance in methicillin resistant S. aureus (MRSA), methicillin sensitive S. aureus (MSSA), methicillin resistant CoNS (MR-CoNS) and methicillin sensitive CoNS (MS-CoNS) were 75.0%, 24%, 18.8% and 11.1%, respectively. The inducible clindamycin resistance was significantly more among MRSA compared to methicillin sensitive S. aureus (MSSA) (P value < 0.0001). Majority of the MRSA isolates were susceptible to clindamycin, vancomycin and linezolid, while most of them were resistant to erythromycin, gentamicin, ciprofloxacin, tetracycline and sulfamethoxazole-trimethoprim. Conclusion: In view of the significant in vitro inducible clindamycin resistance in Staphylococcus spp., we recommend that D test should be used as a mandatory method in microbiology laboratories to avoid misinterpretation of clindamycin result. Detection of inducible clindamycin resistance in Staphylococcus aureus and coagulase-negative staphylococci-a study from South India

Detection of inducible clindamycin resistance in staphylococcus aureus and CONS at tertiary care hospital

Background: The increasing prevalence of Methicillin resistant among staphylococci (MRSA) is an increasing problem. Increasing incidence of infections due to MRSA has led to emphasis on the need for safe & effective agents to treat both systemic & localized Staphylococcal infections. Clindamycin has been used to treat pneumonia & soft tissue and musculoskeletal infections due to MRSA. One important issue in Clindamycin treatment is the risk of clinical failure during therapy caused by MLSB inducible resistance. Objectives: To isolate and identify Staphylococcus aureus and CONS from all clinical samples & to determine the inducible Clindamycin resistance among the Staphylococcus aureus and CONS. Methods: A total of 100 isolates of Staphylococcus aureus and CONS from various samples were isolated. Methicillin resistance was detected by using a 1 µg Oxacillin disc. The D-test was performed using the discs of Clindamycin (CL)(2µg) and Erythromycin (ER)(15µg) placed at a distance of 15mm (centre to centre) along with routine antibiotic susceptibility testing. Results: Among Staphylococcus aureus, MSSA isolates were 32(47.05%) compared to MRSA isolates, 26(38.24%) and among CNS, MSCONS isolates were 8(11.77%) compared to MRCONS 2(2.9%).A total of 12(17.64 %) isolates showed iMLSB, of which 8(11.77%) were MRSA, 2(2.9%) were MSSA and 2(2.9%) MRCONS isolates. Conclusion: Prevalence of inducible Clindamycin resistance among Staphylococcal isolates was significant. Hence the implementation of this D-test routinely, which is simple, reliable & inexpensive will reveals the iMLSB & cMLSB phenotype & prevents the therapeutic failure of Clindamycin.

Detection of inducible clindamycin resistance among clinical isolates of staphylococci from a rural tertiary care hospital

International Journal of Medical Research and Health Sciences, 2013

Clindamycin has been used successfully to treat pneumonia and soft tissue infections caused by methicillin-resistant Staphylococcus aureus. However, Clinical failure of clindamycin therapy has been reported due to multiple mechanisms that confer resistance to Macrolide, Lincosamine and Streptogramin antibiotics. Methods: A total of 96 staphylococcal isolates from different clinical specimens were tested for inducible clindamycin resistance by the disk-diffusion induction test using erythromycin (15µg) disk and clindamycin (2µg) disc placed 15mm (edge to edge). Results: Inducible clindamycin resistance was detected in 47.22% of methicillin-resistant Staphylococcus aureus isolates and in 21.67% of methicillin-sensitive Staphylococcus aureus isolates. In our setting, clindamycin is safe and effective agent to treat both systemic sand localized Staphylococcal infections, but we recommend that staphylococci isolates, particularly methicillin-resistant Staphylococcus aureus, are tested by the D-test routinely to avoid treatment failure.

Inducible Clindamycin Resistance and Biofilm Production among Staphylococci Isolated from Tertiary Care Hospitals in Nepal

Infectious Disease Reports

Resistance to antibiotics, biofilm formation and the presence of virulence factors play important roles in increased mortality associated with infection by staphylococci. The macrolide lincosamide streptogramin B (MLSB) family of antibiotics is commonly used to treat infections by methicillin-resistant isolates. Clinical failure of clindamycin therapy has been reported due to multiple mechanisms that confer resistance to MLSB. This study aims to find the incidence of different phenotypes of MLSB resistance and biofilm production among staphylococci. A total of 375 staphylococci were isolated from different clinical samples, received from two tertiary care hospitals in Nepal. Methicillin resistance was detected by cefoxitin disc diffusion method and inducible clindamycin resistance by D test, according to CLSI guidelines. Biofilm formation was detected by the tissue culture plate method and PCR was used to detect ica genes. Of the total staphylococci isolates, 161 (42.9%) were Staphy...