Gandaki Medical College and Teaching Hospital and Research Centre, Pokhara, Nepal.
JNMA J Nepal Med Assoc. 2021 Nov 15;59(243):1111-1115. doi: 10.31729/jnma.6882.
Staphylococcus aureus, a superbug, resistant to multiple antibiotics led to growing interest in the usage of macrolide-lincosamide-streptogramin B antibiotics, which are now rapidly developing resistance. This study aims to find the prevalence of inducible clindamycin-resistant Staphylococcus aureus among obtained clinical samples from in-patient and out-patient departments of a tertiary care center.
This is a descriptive cross-sectional study done in clinical samples from the in-patient and out-patient departments of a tertiary care center from September 2020-May 2021. Ethical clearance was taken from the Institutional Review Committee (Ref: 068/2077/2078). Staphylococcus aureus were isolated and antibiotic susceptibility tests were performed by disc diffusion method. Inducible clindamycin and methicillin resistance Staphylococcus aureus were detected using D-test and cefoxitin disc according to Clinical and Laboratory Standards Institute guidelines. Convenient sampling was done and the data was analyzed using Statistical Package for Social Sciences version 20. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data.
Among a total of 141 Staphylococcus aureus isolated, the prevalence of inducible clindamycin resistant phenotype was 41 (29.1%) (21.6-36.59 at 95% Confidence Interval). Whereas, 30 (21.3%) were constitutive clindamycin resistant. The inducible 28 (47.5%) and 19 (32.2%) constitutive clindamycin resistance was higher among methicillin-resistant Staphylococcus aureus.
The frequency of inducible clindamycin resistance among methicillin resistant Staphylococcus aureus was high, which alarms the use of macrolide-lincosamide-streptogramin B antibiotics in Staphylococcus aureus infections. Hence, D-test should be performed to detect inducible clindamycin resistance in routine testing to prevent treatment failure.
金黄色葡萄球菌是一种对抗生素具有多重耐药性的超级细菌，这引起了人们对大环内酯类-林可酰胺类-链阳性菌素 B 抗生素的使用兴趣，而这些抗生素现在正迅速产生耐药性。本研究旨在调查从一家三级保健中心的住院和门诊临床样本中获得的耐诱导型克林霉素金黄色葡萄球菌的流行情况。
这是一项描述性的横断面研究，于 2020 年 9 月至 2021 年 5 月在一家三级保健中心的住院和门诊临床样本中进行。本研究已获得机构审查委员会的伦理批准（参考号：068/2077/2078）。通过纸片扩散法进行金黄色葡萄球菌的分离和抗生素药敏试验。根据临床和实验室标准协会的指南，使用 D 试验和头孢西丁纸片检测诱导型克林霉素和耐甲氧西林金黄色葡萄球菌。采用方便抽样法，使用统计软件包（版本 20）对数据进行分析。计算了 95%置信区间的点估计值，以及二项数据的频率和比例。
在总共分离出的 141 株金黄色葡萄球菌中，诱导型克林霉素耐药表型的流行率为 41 株（29.1%）（95%置信区间为 21.6-36.59）。而 30 株为固有型克林霉素耐药。在耐甲氧西林金黄色葡萄球菌中，诱导型克林霉素耐药的有 28 株（47.5%）和 19 株（32.2%），固有型克林霉素耐药的有 28 株（47.5%）和 19 株（32.2%）。
耐甲氧西林金黄色葡萄球菌中诱导型克林霉素耐药的频率较高，这提醒人们在金黄色葡萄球菌感染中使用大环内酯类-林可酰胺类-链阳性菌素 B 抗生素时要谨慎。因此，在常规检测中应进行 D 试验以检测诱导型克林霉素耐药性，以防止治疗失败。
