Prevalence of Inducible Clindamycin Resistance in Methicillin Resistant Staphylococcus aureus Isolated from Different Clinical Samples Received in a Tertiary Care Hospital

摘要

Staphylococcus aureus is recognized as greatest concern associated with both hospital and community acquired infections and if it is methicillin resistant then the severity increases. Erythromycin and clindamycin are considered as treatment of decision. However, protection from erythromycin with phony susceptibility to clindamycin in vitro may prompt remedial disappointment. Hence it is mandatory to study the prevalence of inducible clindamycin resistance. Out of the 875 clinical isolated samples, 403 (46.05%) showed presence of S. aureus. Out of theses 403 samples, 297 (73.70%) were found to be methicillin resistant S. aureus (MRSA) and 106 (26.30 %) were found to be methicillin sensitive S. aureus (MSSA). Further MRSA (Methicillin Resistant S. aureus) samples were analyzed for erythromycin and clindamycin sensitivity and resistivity. Minimum Inhibitory Concentration (MIC) of clindamycin among D test (Disc test) positive MRSA was also analyzed. The occurrence rate of D test positive MRSA strain was found to be more in Hospital Acquired Infections (HAI) as compared with Community Acquired Infection (CAI). Frequency of D test positive MRSA strains were more in Pus samples as compared with urine and blood samples. Further in case of HAI, D test positive MRSA was predominantly found in patients with Diabetic foot patients with postoperative wound and patients with Necrotizing Fasciitis. Out of samples associated with uropathogenic infection in hospital settings, More D test positive MRSA were foundto be associated in patients with catheter installation in without catheter installation. Prolonged hospital stay (>5 days) was observed to be major risk factor for D test positive MRSA. Demographic profile of patients with D test positive MRSA strains revealed the predominance of male in comparison to female.