PREVALENCE OF INDUCIBLE CLINDAMYCIN RESISTANCE IN CLINICAL ISOLATES OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS MEDIATED THROUGH GENE ERMC EXPRESSION
Objective: The objective of this study is to determine the phenotypic and genotypic expression of inducible clindamycin resistance due to the expression of ermA, ermB, and ermC genes in clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) by double disc diffusion and uniplex PCR.Method: This cross-sectional study was conducted in microbiology department of an university teaching hospital. A total of 604 non-duplicate clinical isolates of S. aureus evaluated for MRSA and were subjected to uniplex PCR for ermA, ermB, and ermC genes, respectively.Result: The analysis of 604 isolates showed that 220 (36.42%) were of MRSA. Out of which, 69 (11.42%) were demonstrated as inducible clindamycin resistance by double-disc diffusion method, and among inducible resistant isolates, 25 isolates of ermC (84%) were positive and 4 (16%) were negative, whereas, ermA and ermB genes could not be demonstrated by the genotypic method.Conclusion: We observed that clindamycin may serve as a good alternative and advocated in severe MRSA infection based on susceptibility pattern. We observed D test as a mandatory method to detect inducible clindamycin Staphylococcus. Importantly, ermC gene is a major determinant of resistance to macrolides among MRSA
