Inducible clindamycin resistance in clinical isolates of Staphylococcus aureus due to erm genes, Iran
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Abstract
Background and Objectives: Resistance to macrolide can be mediated by erm and msrA genes in Staphylococcus aureus. There are the evidences that show erm genes may be causative agent of inducible or constitutive resistance. The aim of this study was to investigate the incidence of inducible clindamycin resistance and determine the most frequency of erm and msrA genes among S. aureus isolates.
Materials and Methods: In this study a total of 124 non duplicated clinical isolates of S. aureus were tested with disk diffusion method. All isolates were tested by PCR for mecA, ermA, ermB, ermC and msrA genes.
Results: According to PCR results, 48.4% had mecA gene and 51.6% were mecA negative. By phenotypic D-test method,32.3% revealed inducible resistance and recorded as D and D+. Sensitive and constitutive phenotypes were found in 54.8% and 12.9% of isolates respectively. Inducible clindamycin resistance was more prevalent in MRSA (29%) than MSSA isolates (2.4%). Among studied erm genes, the most frequency genes were ermA and ermC with 41.1% and 17.7% respectively. Three isolates of them had D phenotype, while the PCR results of erm genes were negative. All isolates were negative for ermB or msrA genes.
Conclusion: Since S. aureus isolates with inducible resistance may mutate and change to constitutive resistance, to prevent treatment failure, we suggest that inducible resistance test be performed on erythromycin resistant/clindamycin sensitive isolates.
Guerin F, Buu-Hoi A, Mainardi JL, Kac G, Colardelle N, Vaupre S, et al. Outbreak of methicillin-resistant Staphylococcus aureus with reduced susceptibility to glycopeptides in a Parisian hospital. J Clin Microbiol 2000;38:2985-2988.
Nunes EL, dos Santos KR, Mondino PJ, Bastos Mdo C, Giambiagi-deMarval M. Detection of ileS-2 gene encoding mupirocin resistance in methicillin-resistant Staphylococcus aureus by multiplex PCR. Diagn Microbiol Infect Dis 1999;34:77-81.
Soge OO, Meschke JS, No DB, Roberts MC.Characterization of methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative Staphylococcus spp. isolated from US West Coast public marine beaches. J Antimicrob Chemother 2009;64:1148-55.
Tiwari HK, Sen MR. Emergence of vancomycin resistant Staphylococcus aureus (VRSA) from a tertiary care hospital from northern part of India. BMC Infect Dis 2006;6:156.|
Prabhu K, Rao S, Rao V. Inducible clindamycin resistance in Staphylococcus aureus isolated from clinical samples. J Lab Physicians 2011;3:25-27.
Zelazny AM, Ferraro MJ, Glennen A, Hindler JF, Mann LM, Munro S, et al. Selection of strains for quality assessment of the disk induction method for detection of inducible clindamycin resistance in Staphylococci: a CLSI collaborative study. J Clin Microbiol 2005;43:2613-2615.
Yilmaz G, Aydin K, Iskender S, Caylan R, Koksal I.Detection and prevalence of inducible clindamycin resistance in staphylococci. J Med Microbiol 2007;56(Pt 3):342-345.
Wondrack L, Massa M, Yang BV, Sutcliffe J. Clinical strain of Staphylococcus aureus inactivates and causes efflux of macrolides. Antimicrob Agents Chemother1996;40:992-998.
Prunier AL, Malbruny B, Tande D, Picard B, Leclercq R. Clinical isolates of Staphylococcus aureus with ribosomal mutations conferring resistance to macrolides. Antimicrob Agents Chemother 2002;46:3054-6305.
Aktas Z, Aridogan A, Kayacan CB, Aydin D. Resistance to macrolide, lincosamide and streptogramin antibiotics in staphylococci isolated in Istanbul, Turkey. J Microbiol 2007;45:286-290.
Gupta V, Datta P, Rani H, Chander J. Inducible clindamycin resistance in Staphylococcus aureus: a study from North India. J Postgrad Med 2009;55:176-179.
Navaneeth BV. A preliminary in vitro study on inducible and constitutive clindamycin resistance in Staphylococcus aureus from a South Indian tertiary care hospital. Int J Infect Dis 2006;10:184-185.
Siberry GK, Tekle T, Carroll K, Dick J. Failure of clindamycin treatment of methicillin-resistant Staphylococcus aureus expressing inducible clindamycin resistance in vitro. Clin Infect Dis 2003 1;37:1257-1260.
Steward CD, Raney PM, Morrell AK, Williams PP, McDougal LK, Jevitt L, et al. Testing for induction of clindamycin resistance in erythromycin-resistant isolates of Staphylococcus aureus. J Clin Microbiol 2005;43:1716-1721.
Chelae S, Laohaprertthisarn V, Phengmak M, Kongmuang U, Kalnauwakul S. Detection of inducible clindamycin resistance in staphylococci by disk diffusion induction test. J Med Assoc Thai, 2009 Jul;92:947-951.
Fiebelkorn KR, Crawford SA, McElmeel ML, Jorgensen JH. Practical disk diffusion method for detection of inducible clindamycin resistance in Staphylococcus aureus and coagulase-negative staphylococci. J Clin Microbiol 2003;41:4740-744.
Winn W, Allen S, Janda W, Koneman E, Procop G, Schreckenberger P, et al(2006). Gram-Positive Cocci Part I. In: Koneman’s Color Atlas and Textbook of Diagnostic microbiology. Lippincott Williams & Wilkins,6th ed. Philadelphia, USA, pp. 623-671.
Fernandes CJ, O’Sullivan MV, Cai Y, Kong F, Zeng X, Gilbert GL, et al. Agar dilution method for detection of inducible clindamycin resistance in Staphylococcus spp. J Clin Microbiol2007;45:4018-4020.
Levin TP, Suh B, Axelrod P, Truant AL, Fekete T.Potential clindamycin resistance in clindamycin- susceptible, erythromycin-resistant Staphylococcus aureus: report of a clinical failure. Antimicrob Agents Chemother 2005;49:1222-1224.
Coutinho Vde L, Paiva RM, Reiter KC, de-Paris F, Barth AL, Machado AB. Distribution of erm genes and low prevalence of inducible resistance to clindamycin among staphylococci isolates. Braz J Infect Dis 2010;14:564-568.
Rahbar M, Hajia M. Inducible clindamycin resistance in Staphylococcus aureus: a cross-sectional report. Pak J Biol Sci 2007;10:189-192.
Jethwani UN MSA, Shah Latika N. Detection of inducible clindamycin resistance by an automated system in a tertiary care hospital. Afr J Microbiol Res 2011;5:3.
Dizbay M, Gunal O, Ozkan Y, Ozcan Kanat D, Altuncekic A, Arman D. Constitutive and inducible clindamycin resistance among nosocomially acquired staphylococci. Mikrobiyol Bul 2008;42:217-221.
Tashakori M, Mohseni Moghadam F, Ziasheikholeslami N, Jafarpour P, Bahsoun M, Hadavi M, et al. Staphylococcus aureus nasal carriage and patterns of antibiotic resistance in bacterial isolates from patients and staff in a dialysis center of southeast Iran. Iran J Microbiol 2014;6:5.
Seifi N, Kahani N, Askari E, Mahdipour S, Naderi NM.Inducible clindamycin resistance in Staphylococcus aureus isolates recovered from Mashhad, Iran. Iran J Microbiol 2012;4:82-6.
Cetin ES, Gunes H, Kaya S, Aridogan BC, Demirci M. Distribution of genes encoding resistance to macrolides, lincosamides and streptogramins among clinical staphylococcal isolates in a Turkish university hospital. J Microbiol Immunol Infect 2010;43:524-529.
Westh H, Hougaard DM, Vuust J, Rosdahl VT.Prevalence of erm gene classes in erythromycin- resistant Staphylococcus aureus strains isolated between 1959 and 1988. Antimicrob Agents Chemother 1995;39:369-373.
Saderi H, Emadi B, Owlia P. Phenotypic and genotypic study of macrolide, lincosamide and streptogramin B (MLS ) resistance in clinical isolates of Staphylococcus aureus in Tehran, Iran. Med Sci Monit 2011;17:48-53.
Lina G, Quaglia A, Reverdy ME, Leclercq R, Vandenesch F, Etienne J. Distribution of genes encoding resistance to macrolides, lincosamides, and streptogramins among staphylococci. Antimicrob Agents Chemother1999;43:1062-1066.
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| Issue | Vol 6 No 6 (2014) | |
| Section | Articles | |
| Keywords | ||
| D- test Inducible clindamycin resistance Staphylococcus aureus | ||
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