Ambachew Aklilu, Gebrecherkos Teklay, Ayalew Getnet
Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Medical Microbiology and Immunology, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
Interdiscip Perspect Infect Dis. 2022 Jun 14;2022:6503929. doi: 10.1155/2022/6503929. eCollection 2022.
Clindamycin can serve as an alternative treatment for staphylococcal infections. Routine susceptibility tests may fail to determine inducible type clindamycin resistance and can be a source of failure in clinical therapeutics. Therefore, this study aimed to determine () prevalence, inducible clindamycin resistance pattern, and associated factors among patients attending the University of Gondar Comprehensive Specialized Hospital, Gondar, northwest Ethiopia. . A cross-sectional study was conducted from January to April 2018. Clinical samples were inoculated on appropriate culture media. Standard bacteriological tests, including Gram stain, catalase, and coagulase tests, identified the presence of . The antimicrobial susceptibility tests and the -test were performed by using the Kirby-Bauer disk diffusion technique on the Mueller-Hinton agar. The -test was performed using clindamycin (CLI) 2 ug and erythromycin (ERY) 15 ug disks located approximately 15 mm apart, and the cefoxitin susceptibility test was used to characterize methicillin-resistant (MRSA). The association between infection and different variables was assessed using bivariate and multivariate analysis. A value <0.05 was considered statistically significant. . Of 388 study participants, the overall prevalence of was 17% (66/388). Of these, the inducible type of clindamycin resistance was 25.8% (17/66) and 21.2% (14/66) were MRSA. All isolates were susceptible to chloramphenicol and resistant to tetracycline. A family size of 4-6 (AOR = 2.627, 95% CI (1.030-6.702)) and >7 (AOR = 3.892, 95% CI (1.169-12.959)), inpatient study participants (AOR = 3.198, 95% CI (1.197-8.070)), illness in the previous 4 weeks (AOR = 2.116, 95% CI (1.080-4.145)), and a history of chronic disease (AOR = 0.265, 95% CI (0.094-0.750)) were likely to have infection. . This study shows a considerable high magnitude of MRSA and inducible clindamycin resistance isolates. To rule out clindamycin susceptibility testing, the -test should be routinely performed.
克林霉素可作为葡萄球菌感染的替代治疗药物。常规药敏试验可能无法确定诱导型克林霉素耐药性，并且可能是临床治疗失败的一个原因。因此，本研究旨在确定埃塞俄比亚西北部贡德尔市贡德尔大学综合专科医院患者中金黄色葡萄球菌的流行率、诱导型克林霉素耐药模式及相关因素。2018年1月至4月进行了一项横断面研究。将临床样本接种在合适的培养基上。通过标准细菌学检测，包括革兰氏染色、过氧化氢酶和凝固酶试验，确定金黄色葡萄球菌的存在。采用 Kirby-Bauer 纸片扩散法在 Mueller-Hinton 琼脂上进行药敏试验和 D 试验。D 试验使用相距约15毫米的2 μg 克林霉素（CLI）纸片和15 μg 红霉素（ERY）纸片进行，头孢西丁药敏试验用于鉴定耐甲氧西林金黄色葡萄球菌（MRSA）。采用双变量和多变量分析评估金黄色葡萄球菌感染与不同变量之间的关联。P 值<0.05被认为具有统计学意义。在388名研究参与者中，金黄色葡萄球菌的总体流行率为17%（66/388）。其中，诱导型克林霉素耐药率为25.8%（17/66），MRSA 为21.2%（14/66）。所有分离株对氯霉素敏感，对四环素耐药。家庭规模为4 - 6人（调整后比值比[AOR]=2.627，95%可信区间[CI](1.030 - 6.702)）和>7人（AOR = 3.892，95% CI(1.169 - 12.959)）、住院研究参与者（AOR = 3.198，95% CI(1.197 - 8.070)）、前4周患病（AOR = 2.116，95% CI(1.080 - 4.145)）以及有慢性病病史（AOR = 0.265，95% CI(0.094 - 0.750)）的患者更有可能感染金黄色葡萄球菌。本研究显示 MRSA 和诱导型克林霉素耐药金黄色葡萄球菌分离株的比例相当高。为排除克林霉素药敏试验的干扰，应常规进行 D 试验。
