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Clinical failure of clindamycin therapy has been reported due to multiple mechanisms that include resistance to macrolide, lincosamide and strepto-gramin antibiotics. In vitro routine tests for clindamycin susceptibility may fail to detect inducible clindamycin resistance thus necessitating the need to detect such resistance by a simple D test on routine basis. Among 446 clinical isolates of Staphylococci studied, 145(32.5%) were MRSA and 301(67.84%) were MSSA. Of the 446 staphylococcal isolates 87 (19.50%) were resistant to erythromycin of which 41 (47.12%) showed inducible clindamycin resistance and belonged to the MLSBi phenotype. Among the 41 MLSBi phenotype 36(87.80%) were MRSA and 5(12.19%) were MSSA. Of the 36 MRSA 9(25%) were CA-MRSA and 27 (75%) were HA-MRSA. We conclude therefore, that D-test should be used as a mandatory method in routine disc diffusion testing to detect inducible Clinda-mycin resistance.
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Author(s): Jadhav Savita Vivek Gandham Nageswari Rajesh Sharma Mukesh Kaur Manpreet Misra RN Matnani GB Ujagare MT B Saikat Kumar Ajay
Staphylococcus, inducible clindamycin resistance, D-test