Tigecycline and inducible clindamycin resistance in clinical isolates of methicillin-resistant from Terengganu, Malaysia.

The spread of multidrug-resistant is a public health concern. The inducible macrolide-lincosamide-streptogrammin B (iMLS ) phenotype (or inducible clindamycin resistance) is associated with false clindamycin susceptibility in routine laboratory testing and may lead to treatment failure. Tigecycline resistance remains rare in worldwide. This study aims to determine the antimicrobial susceptibility profiles of clinical isolates of obtained from the main tertiary hospital in Terengganu state, Malaysia, from July 2016 to June 2017. The antimicrobial susceptibilities of 90 methicillin-resistant (MRSA) and 109 methicillin-susceptible (MSSA) isolates were determined by disc diffusion with the iMLS phenotype determined by D-test. Multidrug resistance (MDR) and the iMLS phenotype were more prevalent in MRSA (84.4 and 46.7  %, respectively) compared to MSSA isolates. All five tigecycline-resistant isolates were MRSA. The high incidence of MDR and the iMLS phenotype and the emergence of tigecycline resistance in the Terengganu isolates warrants continuous vigilance.