A report on infection dynamics of inducible clindamycin resistance of Staphylococcus aureus isolated from a teaching hospital in India

Debasmita Dubey; Shakti Rath; Mahesh C Sahu; Subhrajita Rout; Nagen K Debata; Rabindra N Padhy

摘要

Objective:To investigate the infection of hospital-and community-acquired“erythromycin-induced clindamycin resistant”strains or D-test positives of clinical isolates of Staphylococcus aureus (S. aureus) (with and without methicillin resistance) in a hospital. Methods: Strains of S. aureus isolated from clinical specimens were subjected to D-test and antibiotic profiling. Results: Of the total 278 isolates, 140 (50.35%) were D-test positives and the rest were D-test negatives. Further, of 140 (100%) positives, 87 (62.14%) and 53 (37.85%) strains were from males and females, respectively. Of 140 (100%) positives, 117 (83.57%) were methicillin resistant S. aureus and 23 (16.42%) were methicillin sensitive S. aureus;of 140 strains, 103 (73.57%) strains from persons with and 37 (26.42%) were without related infections;of 140 strains, 91 (65%) and 49 (35%) were from hospital-and community-acquired samples, respectively. In 140 strains, 118 (84.28%) with comorbidities and 22 (15.71%) without comorbidities cases were recorded;similarly, persons with prior antibiotic uses contributed 108 (77.14%) and without 32 (22.85%) positive strains. These binary data of surveillance were analyzed by a univariate analysis. It was evident that the prior antibiotic uses and comorbidities due to other ailments were the determinative factors in D-test positivity, corroborated by low P values, P=0.001 1 and 0.002 4, respectively. All isolates (278) were resistant to 17 antibiotics of nine groups, in varying degrees;the minimum of 28%resistance for vancomycin and the maximum of 97%resistance for gentamicin were recorded. Further, of 278 strains, only 42 (15.1%) strains were resistant constitutively to both antibiotics, erythromycin resistant and clindamycin resistant, while 45 (16.2%) strains were constitutively sensitive to both antibiotics (erythromycin sensitive and clindamycin sensitive). Further, of the rest 191 (68.7%) strains were with erythromycin resistant and clindamycin resistant, of which only 140 (50.35%) strains were D-test positives, while the rest 51 (18.34%) strains were D-test negatives. Conclusions: In view of high prevalence of D-test positive S. aureus strains, and equally high prevalence of multidrug resistant strains both in community and hospital sectors, undertaking of D-test may be routinely conducted for suppurative infections.

机译：目的：探讨医院和社区获得的“红霉素诱导的克林霉素耐药”菌株或金黄色葡萄球菌（金黄色葡萄球菌）临床分离株（有或没有甲氧西林耐药性）的感染或D-检验阳性。方法：对从临床标本中分离出的金黄色葡萄球菌进行D-检验和抗生素分析。结果：在总共278个分离株中，有140个（50.35％）是D检验阳性，其余是D检验阴性。此外，在140（100％）阳性中，分别有87（62.14％）和53（37.85％）株来自男性和女性。在140（100％）阳性中，耐甲氧西林的金黄色葡萄球菌为117（83.57％），对甲氧西林敏感的金黄色葡萄球菌为23（16.42％）;在140株菌株中，来自甲氧西林的金黄色葡萄球菌有103（73.57％）株，其中37.（26.42％）无相关感染;在140株菌株中，分别有91株（65％）和49株（35％）来自医院和社区获得的样本。在140株中，记录到118例（84.28％）合并症和22例（15.71％）无合并症;同样，以前使用抗生素的人贡献了108例（77.14％）而没有32例（22.85％）阳性菌株。这些监视的二进制数据通过单变量分析进行了分析。很明显，先前的抗生素使用和其他疾病引起的合并症是D-检验阳性的决定性因素，分别由低P值所证实，分别为P = 0.001 1和0.002 4。所有分离株（278）对9组的17种抗生素均有不同程度的耐药性;记录的万古霉素耐药性最低，为28％，庆大霉素耐药率为97％。此外，在278株中，只有42（15.1％）株对红霉素和克林霉素都具有组成型耐药，而45（16.2％）株对两种抗生素（对红霉素和克林霉素敏感）都对组成型敏感。此外，其余191株（68.7％）的菌株对红霉素和克林霉素具有抗性，其中只有140株（50.35％）是D检验阳性，而其余51株（18.34％）是D检验阴性。结论：鉴于D-test阳性金黄色葡萄球菌菌株的高流行，以及社区和医院部门中多药耐药菌株的高流行，对于化脓性感染可常规进行D-test。

A report on infection dynamics of inducible clindamycin resistance of Staphylococcus aureus isolated from a teaching hospital in India

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