Failure of Clindamycin Treatment of Methicillin-Resistant Staphylococcus aureus Expressing Inducible Clindamycin Resistance in Vitro

George K. Siberry, Tsigereda Tekle, Karen Carroll, James Dick

Research output: Contribution to journalArticlepeer-review

Abstract

We report a case of a surgical site infection caused by clindamycin-susceptible, erythromycin-resistant methicillin-resistant Staphylococcus aureus (MRSA) that did not respond to treatment with clindamycin. The MRSA isolate obtained after treatment was resistant to clindamycin but was found to be identical by pulsed-field gel electrophoresis to the clindamycin-susceptible isolate obtained before treatment. A post hoc erythromycin-induction test (D test) confirmed the presence of in vitro inducible macrolide-lincosamide-streptogramin B resistance (iMLS) in the pretreatment isolate. Erythromycin induction testing confirmed in vitro iMLS in 90 (56%) of 161 erythromycin-resistant, clindamycin-susceptible clinical S. aureus isolates overall and in a significantly higher proportion (78%) of methicillin-susceptible S. aureus isolates from pediatric patients. Our clinical laboratory currently tests all S. aureus isolates for iMLS before reporting clindamycin susceptibility.

Original languageEnglish (US)
Pages (from-to)1257-1260
Number of pages4
JournalClinical Infectious Diseases
Volume37
Issue number9
DOIs
StatePublished - Nov 1 2003

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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