Agar dilution method for detection of inducible clindamycin resistance in Staphylococcus spp

J Clin Microbiol. 2007 Dec;45(12):4018-20. doi: 10.1128/JCM.01158-07. Epub 2007 Oct 17.

Abstract

We describe the development and validation of an agar dilution method for the detection of inducible clindamycin resistance by using 227 previously characterized erythromycin-resistant, clindamycin-susceptible Staphylococcus sp. isolates. Mueller-Hinton agar with defibrinated horse blood containing a range of erythromycin concentrations (1 to 8 mg/liter) combined with clindamycin at 0.5 mg/liter was used to determine the optimal concentration that produced growth of inducible isolates while inhibiting that of isolates without the inducible phenotype. A concentration of clindamycin of 0.5 mg/liter with erythromycin at 1 mg/liter was the optimal combination for detection of inducible resistance and resulted in a sensitivity of 100% (95% confidence interval [CI], 97.9 to 100) and a specificity of 100% (95% CI, 93.0 to 100). Attention must be paid to ensuring that a sufficient inoculum has been used, since an inoculum below the standard 10(7) bacteria/ml may result in false-negative results. This method has been incorporated into routine use in our laboratory.

Publication types

  • Validation Study

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Clindamycin / pharmacology*
  • Culture Media / chemistry
  • Drug Resistance, Bacterial*
  • Erythromycin / pharmacology
  • Gene Expression Regulation / drug effects
  • Microbial Sensitivity Tests / methods*
  • Sensitivity and Specificity
  • Staphylococcus / drug effects*

Substances

  • Anti-Bacterial Agents
  • Culture Media
  • Clindamycin
  • Erythromycin