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KMID : 1101320060380010038
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Korean Journal of Clinical Laboratory Science
2006 Volume.38 No. 1 p.38 ~ p.44
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An Easy Method of Disk Diffusion Antibiotic Susceptibility Test for Detection of Erythromycin-induced Resistance to Clindamycin in Staphylococci
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Joo Sae-Ick
Lee Hyun
Lim Kyu-Sang
Kim Eui-Chong
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Abstract
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A simple and easy modification of AST by disk diffusion was tested for the detection of induced clindamycin resistant Staphylococci and their antimicrobial susceptibility at the same time. The incidence of inducible clindamycin resistant staphylococci in blood culture and their MIC characterization at Seoul National University Hospital was analyzed by an AST contained disk approximation test (D-zone test) and Etest, respectively. Of the total 309 staphylococcal isolates, 139 (45%) isolates presented constitutive resistance to ERY and CLI (ERY-R, CLI-R phenotype), and 59 were ERY-I/R and CLI-S phenotypes. Of the 59 isolates, 19 (32%) isolates were inducible resistant to CLI. The incidence was higher in S. aureus (66.7%) than coagulase-negative staphylococci (CNS, 26.0%). Especially, methicillin-resistant staphylococci (MRSA, 100%; MRCNS, 45.5%) presented higher inducibility than methicillin susceptible (MSSA, 50%; MSCNS, 20%). For most of the inducible clindamycin resistant staphylococci (15 of 19 isolates), their ERY MIC were high (>128 μg/mL) and were methicillin resistant. The remaining 4 isolates were methicillin susceptible and their ERY MIC were of intermediate concentrations (1-4 μg/mL). We concluded that suscetibility testing of staphylococci, especially methicillin resistant, should include the D-zone test.
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KEYWORD
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D-zone test, Inducible clindamycin resistant staphylococci, Incidence of inducible MLSB, Methicillin resistant staphylococci
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