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1: Diagn Microbiol Infect Dis. 2007 Feb 12; [Epub ahead of print]
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Inducible clindamycin resistance in Staphylococcus aureus
isolates causing bacteremia at a university hospital in southern
Taiwan.
Janapatla RP, Yan JJ, Huang AH, Chen HM, Wu HM, Wu JJ.
Department of Medical Laboratory Science and Biotechnology, College of
Medicine, National Cheng-Kung University, Tainan 70101, ROC Taiwan.
A major concern while prescribing clindamycin to treat infections
caused by inducible macrolide, lincosamide, and group B
streptogramin (iMLS(B))-resistant strains is clinical therapy
failure. In this study, we determined the prevalence,
mechanism, and clonality of the iMLS(B) phenotype in
oxacillin-resistant Staphylococcus aureus (ORSA) and
oxacillin-susceptible S. aureus (OSSA). Among the 729 OSSA
isolates collected from July 1995 to March 2006, 72 (10%) were
clindamycin sensitive (Cli(s)) and erythromycin resistant
(Erm(r)), and 55 (8%) had the iMLS(B) phenotype. In the 709
ORSA isolates collected from January 1997 to March 2006, 31
(4%) were Cli(s) and Erm(r), and 29 (4%) isolates
demonstrated the iMLS(B) phenotype. In OSSA, ermC was the
predominant (51 of 55 isolates) genetic determinant responsible
for the iMLS(B) phenotype, whereas in ORSA, ermA was
predominant (27 of 29). Pulsed-field gel electrophoresis showed
that 8 pulsed types (RA to RH) were present in ORSA isolates (n
= 27), and pulsed type RC was predominant in 17 isolates with 5
identifiable subtypes (RC1 to RC5); this type was prevalent from
November 1997 to June 2004. In the OSSA (n = 24) isolates, 14
different pulsed types (SA to SN) were identified, but none was
predominant. These results indicate that the incidence of
iMLS(B) resistance phenotype is higher in OSSA than ORSA in
Taiwan, and the genetic determinants responsible for the
iMLS(B) phenotype vary in OSSA and ORSA.
Related Links
Phenotypes and genotypes of
erythromycin-resistant Streptococcus
[Antimicrob Agents Chemother. 1999]
Testing for induction of clindamycin
resistance in erythromycin-resistant
[J Clin Microbiol. 2005]
Prevalence of polyclonal
mefA-containing isolates [J Clin Microbiol. among 2000]
Failure of clindamycin treatment of
methicillin-resistant [Clin Staphylococcus
Infect Dis. 2003]
Practical disk diffusion method for
detection of inducible [J Clin clindamycin
Microbiol. 2003]
See all Related Articles...
PMID: 17300897 [PubMed - as supplied by publisher]
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