PMID- 25052113
OWN - NLM
STAT- MEDLINE
DCOM- 20141113
LR  - 20191112
IS  - 0374-9096 (Print)
IS  - 0374-9096 (Linking)
VI  - 48
IP  - 3
DP  - 2014 Jul
TI  - [Macrolide-lincosamide-streptogramin B (MLSB) resistance phenotypes in clinical 
      Staphylococcus isolates and investigation of telithromycin activity].
PG  - 469-76
AB  - Staphylococci are one of the most common pathogens isolated from nosocomial and 
      community acquired infections. Antibiotics such as clindamycin and erythromycin 
      have been useful options for treating skin and soft-tissue infections caused by 
      staphylococci. However, expression of macrolide-lincosamide-streptogramin B 
      resistance (MLSB) can limit the effectiveness of these drugs. The aims of this 
      study were to investigate the prevalence and phenotypes of MLSB resistance in 
      staphylococcus strains isolated from clinical samples and to determine the 
      telithromycin activity against these isolates. A total of 218 strains [92 
      Staphylococcus aureus and 126 coagulase-negative staphylococci (CNS)] isolated 
      from different clinical samples (wound, abscess, blood, sterile body fluids, 
      catheter, upper respiratory tract samples) between February 2011 to December 2012 
      were included in the study. The isolates were identified by using conventional 
      methods and automated bacterial identification system (BD Phoenix 100 System, 
      Becton Dickinson, USA). Methicillin resistance of the isolates was determined 
      with the use of cefoxitin (30 microg) disk and telithromycin (15 microg) activity was 
      detected by Kirby-Bauer disk diffusion method. MLSB resistance phenotypes were 
      investigated by the D-test method using erythromycin (15 microg) and clindamycin (2 
      microg) disks. Of 92 S.aureus isolates, 23 were methicillin-resistant (MRSA) and 69 
      were methicillin-susceptible (MSSA), whereas 78 of 126 CNS isolates were 
      methicillin-resistant (MRCNS) and 48 were methicillin-susceptible (MSCNS). 
      Hundred and seventy-two (79%) isolates were found as erythromycin-resistant, and 
      the rates of erythromycin resistance in MRSA, MSSA, MRCNS and MSCNS strains were 
      83%, 71%, 95% and 63%, respectively. Inducible type of MLSB resistance (iMLSB 
      type) was observed in 26%, 6%, 51% and 33%; chromosomal resistance (cMLSB type) 
      in 32%, 27%, 27% and 17% and efflux pump connected resistance (MSB type) in 42%, 
      67%, 22% and 50% of the MRSA, MSSA, MRCNS and MSCNS, respectively. Forty-four 
      (20%) strains were found susceptible to both clindamycin and erythromycin (S type 
      resistance). Resistance due to enzymatic inactivation (L type) was observed only 
      in two of the CNS strains (0.9%), one was methicillin-resistant and the other was 
      susceptible. Total telithromycin resistance was detected as 26.6% (n= 58), while 
      the resistance rates in MRSA, MSSA, MRCNS and MSKNS isolates were 35%, 35%, 28% 
      and 8%, respectively. Telithromycin resistance rate was 34% (58/172) in 
      erythromycin-resistant isolates. However, all erythromycin-susceptible isolates 
      (n= 46) were also susceptible to telithromycin. Telithromycin-resistant isolates 
      frequently exhibited cMLSB phenotype (39/44; 67.2%), followed by MSB (16/72; 
      27.6%) and iMLSB (3/56; 5.2%). In conclusion, clindamycin is still an effective 
      antibiotic for the treatment of staphylococcal infections in our hospital, 
      however, 34% resistance rate against telithromycin may limit the use of this 
      agent which is an alternative for the treatment of infections caused by 
      clindamycin and erythromycin-resistant strains.
FAU - Uzun, Berrin
AU  - Uzun B
AD  - Ataturk Training and Research Hospital, Microbiology Laboratory, Izmir, Turkey. 
      berrinuzun@gmail.com.
FAU - Gungor, Serdar
AU  - Gungor S
FAU - Pektas, Bayram
AU  - Pektas B
FAU - Aksoy Gokmen, Aysegul
AU  - Aksoy Gokmen A
FAU - Yula, Erkan
AU  - Yula E
FAU - Kocal, Funda
AU  - Kocal F
FAU - Kaya, Selcuk
AU  - Kaya S
LA  - tur
PT  - Journal Article
TT  - Klinik stafilokok izolatlarinda makrolid-linkozamid-streptogramin B (MLSB) direnc 
      fenotipleri ve telitromisin etkinliginin arastirilmasi.
PL  - Turkey
TA  - Mikrobiyol Bul
JT  - Mikrobiyoloji bulteni
JID - 7503830
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Ketolides)
RN  - 0 (Lincosamides)
RN  - 0 (Macrolides)
RN  - 3131-03-1 (Streptogramin B)
RN  - KI8H7H19WL (telithromycin)
SB  - IM
MH  - Anti-Bacterial Agents/*pharmacology
MH  - *Drug Resistance, Multiple, Bacterial
MH  - Humans
MH  - Ketolides/*pharmacology
MH  - Lincosamides/pharmacology
MH  - Macrolides/pharmacology
MH  - Phenotype
MH  - Staphylococcal Infections/*microbiology
MH  - Staphylococcus/classification/*drug effects/isolation & purification
MH  - Streptogramin B/pharmacology
EDAT- 2014/07/24 06:00
MHDA- 2014/11/14 06:00
CRDT- 2014/07/24 06:00
PHST- 2014/07/24 06:00 [entrez]
PHST- 2014/07/24 06:00 [pubmed]
PHST- 2014/11/14 06:00 [medline]
AID - 10.5578/mb.7748 [doi]
PST - ppublish
SO  - Mikrobiyol Bul. 2014 Jul;48(3):469-76. doi: 10.5578/mb.7748.