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Seppälä, H., Klaukka, T., Vuopio-Varkila, J., Muotiala, A., Helenius, H., Lager, K., et al. (1997) The Effect of Changes in the Consumption of Macrolide Antibiotics on Erythromycin Resistance in Group A Streptococci in Finland. The New England Journal of Medicine, 337, 441-446.
https://doi.org/10.1056/NEJM199708143370701

has been cited by the following article:

• TITLE: Clindamycin Resistance among Methicillin Resistant Staphylococcus aureus Isolated from Human and Respective Household Swine in Greater Kabale Region—South Western Uganda

  AUTHORS: Andrew Baguma, Benson Musinguzi, Moses Mpeirwe, Joel Bazira

  KEYWORDS: Clindamycin Resistance, cMLSB and iMLSB Phenotypes, MRSA

  JOURNAL NAME: Advances in Infectious Diseases, Vol.9 No.4, December 12, 2019

  ABSTRACT: Introduction: S. aureus is recognized as the common cause of nosocomial and community-acquired infections. Macrolide-Lincosamide-Streptogramin B (MLSB) is thought to be alternative therapies against MRSA infections. Clindamycin is the most favored agent because of exceptional pharmacokinetic characteristics. However, increasing resistance to clindamycin among MRSA strains is a serious challenge. The current study investigated the profile of clindamycin resistance among MRSA isolates from Humans, and their respective livestock (in particular swine) using D-test in greater Kabale region. Materials and Methods: Three hundred phenotypic MRSA isolates previously isolated from Humans and swine were confirmed by mecA PCR. We performed D-test using erythromycin (15 μg) and clindamycin (2 μg) discs in accordance to Clinical and Laboratory Standards Institute (CLSI) protocol. Results: Of all 300 MRSA isolates, 6% (n = 18) were sensitive to Erythromycin and Clindamycin (S). The rate of inducible clindamycin resistance (iMLSB) was 42% (n = 125) and 38% (n = 115) was resistance to both Erythromycin and clindamycin (cMLSB). However, 14% (n = 42) were resistant to erythromycin but sensitive to clindamycin (MS) without “D” zone negative. Conclusion: Clindamycin resistance (both cMLSB and iMLSB) among MRSA was high and “D” test should be adopted routinely during antimicrobial susceptibility testing by disc diffusion testing to rapidly detect iMLSB and cMLSB.