Inducible clindamycin resistance in Staphylococcus aureus: Now and then | ||
| Microbes and Infectious Diseases | ||
| Articles in Press, Accepted Manuscript, Available Online from 30 March 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/mid.2025.350255.2436 | ||
| Authors | ||
| Deepa Devhare* ; Mahadevan Kumar; Meera Modak; Bharati Dalal | ||
| Department of Microbiology Bharati Vidyapeeth Medical College, Pune: 411043, India | ||
| Abstract | ||
| Background: Staphylococcus aureus and specifically methicillin resistance (MRSA) is a major cocern worldwide, posing a significant challenge due to limited treatment options. Clindamycin, a macrolide-lincosamide-streptogramin B (MLSB) antibiotic, is frequently used for treatment of Staphylococcus aureus. Ribosomal methylation mediated resistance resulted in inducible (iMLSB) or constitutive (cMLSB) resistance in Staphylococcus aureus . This study was planned to determine the prevalence and trends of iMLSB resistance in S. aureus isolates over four years. Methods: A retrospective observational study carried out from 2019-2022 in a tertiary care hospital. Toytal 1222 non-duplicate S. aureus isolates from clinical samples were analysed. Antimicrobial susceptibility, including methicillin and clindamycin resistance, was determined using the Vitek 2 compact automated system. iMLSB, cMLSB, phenotypes were categorized based on susceptibility patterns of erythromycin and clindamycin. Results: Among 1222 isolates, 55.97% were MRSA. All Staphylococcus aureus isolates were sensitive to vancomycin, linezolid, and daptomycin. The prevalence of iMLSB was 16% in MSSA and 45.76% in MRSA, with no significant year-wise change in MSSA. MRSA showed rise in percentage of iMLSB (from 40.5% to 58.87%). Constitutive resistance was observed in 1.48% of MSSA and 7.89% of MRSA isolates. Conclusion: The increasing trend of iMLSB resistance in MRSA is alarming. Clindamycin is an effective option for treating MRSA, but caution is warranted due to potential resistance development. The study highlights the importance of periodic surveillance of antimicrobial susceptibility pattern for better implementation of antimicrobial stewardship and infection control measures. | ||
| Keywords | ||
| MLSB resistance; MRSA; rising trend; antimicrobial stewardship | ||
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