STUDY ON PHENOTYPIC DETECTION OF INDUCIBLE CLINDAMYCIN RESISTANCE AMONG STAPHYLOCOCCUS AUREUS ISOLATES BY USING THE LOWER LIMIT OF RECOMMENDED INTER DISK DISTANCE: A Microbiological Study of MLSB Resistance Phenotypes and MRSA Prevalence

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Durgesh Kumar Yadav
Department of Microbiology, Index Medical College Hospital & Research Centre, Indore, Malwanchal University, Madhya Pradesh, India.
Ramanath Karicheri
Professor, Department of Microbiology, Index Medical College Hospital & Research Centre, Indore, Madhya Pradesh, India.

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Staphylococcus aureus, Inducible Clindamycin Resistance, D-test, MRSA, MLSB Resistance, Phenotypic Detection

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Background:
Staphylococcus aureus is one of the most important human pathogens responsible for a wide range of community-acquired and hospital-acquired infections. The emergence of methicillin-resistant Staphylococcus aureus (MRSA) and inducible clindamycin resistance has become a major therapeutic challenge. Clindamycin is commonly used for the treatment of staphylococcal infections because of its excellent tissue penetration and oral bioavailability. However, inducible resistance mediated through the MLSB phenotype may result in treatment failure if not detected properly.

Aim and Objectives:
The present study was conducted to determine the prevalence of MRSA strains among clinical isolates of Staphylococcus aureus, to detect inducible clindamycin resistance by D-test using the lower limit of recommended inter-disk distance, and to evaluate the antibiotic resistance pattern of the isolates.

Materials and Methods:
This study was carried out in the Department of Microbiology, Index Medical College and Hospital, Indore, from April 2020 to April 2021. A total of 613 clinical samples including pus, urine, blood, sputum, and endotracheal aspirates were collected and processed by standard microbiological procedures. Identification of Staphylococcus aureus was done by Gram staining, catalase test, coagulase test, and mannitol fermentation test. Antibiotic susceptibility testing was performed by Kirby-Bauer disc diffusion method according to CLSI guidelines. Inducible clindamycin resistance was detected by D-test using erythromycin and clindamycin discs placed at 15 mm edge-to-edge distance.

Results:
Among the isolates of Staphylococcus aureus, varying resistance patterns to commonly used antibiotics were observed. The D-test identified inducible MLSB resistance among erythromycin-resistant and clindamycin-sensitive isolates. MRSA strains showed comparatively higher resistance rates than MSSA strains. Detection of inducible clindamycin resistance was found to be important for preventing therapeutic failure and guiding appropriate antibiotic therapy.

Conclusion:
Routine detection of inducible clindamycin resistance by D-test should be included in antimicrobial susceptibility testing of Staphylococcus aureus isolates. Early identification of MLSB resistance phenotypes helps clinicians in selecting appropriate antimicrobial therapy and reducing the spread of resistant strains.

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Mr. Durgesh Kumar Yadav is a postgraduate researcher in Medical Laboratory Technology with specialization in Microbiology. He completed his academic research work at Index Medical College Hospital & Research Centre, Indore, under Malwanchal University. His research interests include antimicrobial resistance, clinical microbiology, infectious diseases, and antibiotic susceptibility testing.

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Dr. Ramanath Karicheri is a Professor in the Department of Microbiology at Index Medical College Hospital & Research Centre, Indore. He has extensive academic and research experience in clinical microbiology, antimicrobial resistance, infectious diseases, and laboratory diagnostics. He has guided several postgraduate research projects in the field of medical laboratory sciences and microbiology.

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Online Version

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जून 1, 2026

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The Advances in Medical Laboratory Science Research Series: Emerging Research in Histopathology, Diagnostics and Allied Healthcare Sciences

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The data used in this study were collected and analyzed during the current research work at the Department of Microbiology, Index Medical College Hospital & Research Centre, Indore. The datasets generated and analyzed during the study are available from the corresponding author upon reasonable academic request.

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978-81-687767-0-8

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Yadav, D. K., & Karicheri, R. (Eds.). (2026). STUDY ON PHENOTYPIC DETECTION OF INDUCIBLE CLINDAMYCIN RESISTANCE AMONG STAPHYLOCOCCUS AUREUS ISOLATES BY USING THE LOWER LIMIT OF RECOMMENDED INTER DISK DISTANCE: A Microbiological Study of MLSB Resistance Phenotypes and MRSA Prevalence: Vol. BOOK 1 Volume 1. Research Edge and Publication. https://books.researchedgeandpublication.com/index.php/REP/catalog/book/10