Inducible Clindamycin Resistant Staphylococcus aureus in Iran: A Systematic Review and Meta-analysis

Journal of Medical Bacteriology

卷:4

Aminreza Amini¹  Mohammad Rahbar²  Mahboubeh Naderinasab³  Ahmadreza Zarifian⁴  Emran Askari⁴  Yasin Setayesh⁴ 

[1] Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, IR Iran;

[2] Department of Microbiology, Reference Health Laboratories Research Center, Deputy of Health, Ministry of Health and MedicalEducation, Tehran, IR Iran AND Antimicrobial Resistance Research Center, Tehran University of Medical sciences, Tehran, IR Iran;

[3] Microbiology Laboratory, Central Laboratory, Imam Reza Hospital, Mashhad, IR Iran;

[4] Student Research Committee, Mashhad University of Medical Sciences, Mashhad, IR Iran;

关键词: Staphylococcus aureus, Inducible resistance, Cindamycin, Iran, Systematicreview;   

DOI  :  

来源: DOAJ

【 摘 要 】

Introduction: Staphylococcus aureus is a prominent human pathogen. One of the drugs used in the treatment of staphylococcal infections (particularly infections of skin and soft tissue), is clindamycin. Resistance to clindamycin includes two types: inducible and constitutive. Routine laboratory methods of antibiotic susceptibility testing cannot detect the inducible type and D- test is required for its detection. The purpose of this systematic review was to determine the relative prevalence of this type of resistance in Iran.

Methods: Search terms "inducible clindamycin resistant", "D-test", "Staphylococcus aureus" and "Iran" were used to find relevant articles in PubMed, Google Scholar and two Persian search engines. Also, the abstracts of the recent national microbiology congresses were checked.All studies used D-test to find iMLSB  (inducible macrolide, lincosamide and streptograminB resistance) phenotype among clinical isolates (not nasal swabs) of S. aureus, were included. In order to perform meta-analysis, we used “comprehensive meta-analysis” software (ver. 2).

Results: In total, 9 articles and 8 abstracts related to the topic of the study were found. Random effects meta-analyses showed a pooled estimate for percentage of iMLSB  phenotype among 2683 samples of S. aureus was about 10% (95% confidence interval: 0.07-0.12). Using the fixed effect model, the odds of positive iMLSB  in methicillin-resistant S. aureus was about 5 times more likely to occur in comparison with methicillin-susceptible S. aureus (95% CI: 3.49 to 7.76).

Conclusion: Fortunately, the relative frequency of inducible resistance to clindamycin in our country is relatively low. However, we believe that D-test should be performed for all erythromicin-resistant  isolates  in  order  to  identify  inducible  resistance  to  clindamycin.Moreover, reevaluation of inducible reistance to clindamycin in forthcoming years is highly recommended.

【 授权许可】

Unknown