Tigecycline and inducible clindamycin resistance in clinical isolates of methicillin-resistant Staphylococcus aureus from Terengganu, Malaysia

J Med Microbiol. 2019 Sep;68(9):1299-1305. doi: 10.1099/jmm.0.000993.

Abstract

The spread of multidrug-resistant Staphylococcus aureus is a public health concern. The inducible macrolide-lincosamide-streptogrammin B (iMLSB ) phenotype (or inducible clindamycin resistance) is associated with false clindamycin susceptibility in routine laboratory testing and may lead to treatment failure. Tigecycline resistance remains rare in S. aureus worldwide. This study aims to determine the antimicrobial susceptibility profiles of clinical isolates of S. aureus obtained from the main tertiary hospital in Terengganu state, Malaysia, from July 2016 to June 2017. The antimicrobial susceptibilities of 90 methicillin-resistant S. aureus (MRSA) and 109 methicillin-susceptible S. aureus (MSSA) isolates were determined by disc diffusion with the iMLSB phenotype determined by D-test. Multidrug resistance (MDR) and the iMLSB phenotype were more prevalent in MRSA (84.4 and 46.7 %, respectively) compared to MSSA isolates. All five tigecycline-resistant isolates were MRSA. The high incidence of MDR and the iMLSB phenotype and the emergence of tigecycline resistance in the Terengganu S. aureus isolates warrants continuous vigilance.

Keywords: inducible clindamycin resistance; methicillin-resistant S. aureus; methicillin-susceptible S. aureus; multidrug resistance; tigecycline resistance.

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Clindamycin / pharmacology*
  • Drug Resistance, Multiple, Bacterial*
  • Female
  • Humans
  • Malaysia / epidemiology
  • Male
  • Methicillin-Resistant Staphylococcus aureus / drug effects*
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Microbial Sensitivity Tests
  • Phenotype
  • Prevalence
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / microbiology*
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / isolation & purification
  • Tertiary Care Centers
  • Tigecycline / pharmacology*

Substances

  • Anti-Bacterial Agents
  • Clindamycin
  • Tigecycline