Detection of Inducible clindamycin resistance in nasal carriers of Staphylococcus aureus among healthcare workers

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Original Article

Author Details : Jenia Bidani, Loveena Oberoi*, Anuradha Malhotra, Shailpreet Kaur Sidhu, Sapna Soneja

Volume : 6, Issue : 2, Year : 2020

Article Page : 103-106

https://doi.org/10.18231/j.ijmmtd.2020.022

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Abstract

Introduction : Staphylococcus aureus (S. aureus) is recognized as one of the most common microrganisms
causing nosocomial and community-acquired infections. Nasal carriage of Staphylococcus aureus is
becoming an increasing problem among healthcare workers and in the healthy community individuals.
General populations with persistent Staphylococcus aureus nasal carriage rates at 10% to 20%, and up
to 50% are intermittent carriers. Furthermore, carrier levels of 25% have been reported among healthcare
workers(HCW’s). Strains with inducible clindamycin resistance (ICR) are difficult to detect in the routine
laboratory as they appear to be resistant to erythromycin and sensitive to clindamycin in vitro when not
placed adjacent to each other. In such cases, in vivo treatment with clindamycin may select constitutive erm
mutants leading to clinical therapeutic failure.
Materials and Methods: 100 nasal swabs samples were collected during January 2019 to November
2019. Isolates were identified using standard microbioloical procedures and MRSA determined by the
disk diffusion method. The D-test was performed for detection of Inducible clindamycin resistance isolates
with Clinical Laboratory Standard Institute guidelines.
Results: Out of 18 S. aureus isolated, 33.3 were MRSA. Of 18 S. aureus isolates tested for ICR by D-test, 6
(33.3%) yielded inducible resistance. Inducible clindamycin resistance was found to be significantly higher
among MRSA than MSSA isolates.
Conclusion: Beside personal hygiene practices of healthcare workers, regular implementation of infection
control practices, including screening of nasal carriages and microbial flora in our hospital are necessary to
prevent spread of MRSA. It is also advisable to perform routine nasal decolonization of healthcare workers
using mupirocin ointment to prevent transmission of these organisms.

Keywords: S. aureus nasal carriage, Healthcare workers, MRSA, Inducible Clindamycin Resistance.

How to cite : Bidani J, Oberoi L, Malhotra A, Sidhu S K, Soneja S , Detection of Inducible clindamycin resistance in nasal carriers of Staphylococcus aureus among healthcare workers. IP Int J Med Microbiol Trop Dis 2020;6(2):103-106

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