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KMID : 1120220190100010025
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Osong Public Health and Research Perspectives
2019 Volume.10 No. 1 p.25 ~ p.31
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Analysis of Resistance to Macrolide?Lincosamide?Streptogramin B Among mecA-Positive Staphylococcus Aureus Isolates
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Khodabandeh Mahmoud
Mohammadi Mohsen
Abdolsalehi Mohammad Reza
Alvandimanesh Azadeh
Gholami Mehrdad
Bibalan Meysam Hasannejad
Pournajaf Abazar
Kafshgari Ramin
Rajabnia Ramazan
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Abstract
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Objectives: Genetic determinants conferring resistance to macrolide, lincosamide, and streptogramin B (MLSB) via ribosomal modification such as, erm, msrA/B and ereA/B genes are distributed in bacteria. The main goals of this work were to evaluate the dissemination of MLSB resistance phenotypes and genotypes in methicillin-resistant Staphylococcus aureus (MRSA) isolates collected from clinical samples.
Methods: A total of 106 MRSA isolates were studied. Isolates were recovered from 3 hospitals in Tehran between May 2016 to July 2017. The prevalence of MLSB-resistant strains were determined by D-test, and then M-PCR was performed to identify genes encoding resistance to macrolides, lincosamides, and streptogramins in the tested isolates.
Results: The frequency of constitutive resistance MLSB, inducible resistance MLSB and MSB resistance were 56.2%, 22.9%, and 16.6%, respectively. Of 11 isolates with the inducible resistance MLSB phenotype, ermC, ermB, ermA and ereA were positive in 81.8%, 63.6%, 54.5% and 18.2% of these isolates, respectively. In isolates with the constitutive resistance MLSB phenotype, the prevalence of ermA, ermB, ermC, msrA, msrB, ereA and ereB were 25.9%, 18.5%, 44.4%, 0.0%, 0.0%, 11.1% and 0.0%, respectively.
Conclusion: Clindamycin is commonly administered in severe MRSA infections depending upon the antimicrobial susceptibility findings. This study showed that the D-test should be used as an obligatory method in routine disk diffusion assay to detect inducible clindamycin resistance in MRSA so that effective antibiotic treatment can be provided.
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KEYWORD
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drug resistance, methicillin-resistant S. aureus, inducible clindamycin resistance
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