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Chapter 5.9 : Detection of Inducible Clindamycin Resistance in spp., , and spp. Beta-Hemolytic Group

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Detection of Inducible Clindamycin Resistance in spp., , and spp. Beta-Hemolytic Group, Page 1 of 2

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Abstract:

Inducible clindamycin resistance (ICR) in staphylococci and streptococci can be detected by agar disk diffusion (D-zone test) or broth microdilution methods. The CLSI recommends testing for inducible clindamycin resistance in all staphylococci, , and beta-hemolytic streptococci that are erythromycin resistant and clindamycin susceptible or intermediate prior to reporting clindamycin results. Isolates with inducible clindamycin resistance should be reported as clindamycin resistant alongside a comment stating that clindamycin resistance is presumed by the presence of inducible resistance and clindamycin may still be effective in some patients ( ). Both the D-zone test and the broth microdilution method are described here. See Appendix 5.9–1 for a summary of testing conditions for staphylococci and streptococci using these methods. Also refer to procedures 5.1 and 5.2 for details of performing the disk diffusion and broth microdilution MIC methods, respectively.

Citation: Leber A. 2016. Detection of Inducible Clindamycin Resistance in spp., , and spp. Beta-Hemolytic Group, p 5.9.1-5.9.7. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch5.9
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Figures

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Figure 5.9–1

Positive D-zone test for inducible clindamycin resistance.

Citation: Leber A. 2016. Detection of Inducible Clindamycin Resistance in spp., , and spp. Beta-Hemolytic Group, p 5.9.1-5.9.7. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch5.9
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References

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1. CLSI. 2015. Performance Standards for Antimicrobial Susceptibility Testing. 25th Informational Supplement, M100-S25. CLSI, Wayne, PA.
2. CLSI. 2015. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically, 10th ed. Approved standard M7-A10. CLSI, Wayne, PA.
3. CLSI. 2015. Performance Standards for Antimicrobial Disk Susceptibility Tests, 12th ed. Approved standard M2-A12. CLSI, Wayne, PA.
4. Bowling JE, Owens AE, McElmeet ML, Fulcher LC, Herrara ML, Wickes BL, Jorgenson JH. 2010. Detection of inducible clindamycin resistance in beta-hemolytic streptococci by using CLSI broth microdilution test and erythromycin-clindamycin combinations. J Clin Microbiol 48:22752277.
5. Jorgensen JH, McElmeel ML, Fulcher LC, McGee L, Glennen A. 2011. Evaluation of disk approximation and single-well broth tests for detection of inducible clindamycin resistance in Streptococcus pneumoniae. J Clin Microbiol 49:33323333.
6. Lewis JS 2nd, Jorgensen JH. 2005 Inducible clindamycin resistance in staphylococci: should clinicians and microbiologists be concerned? Clin Infect Dis 40:280285.
7. Swenson JM, Brasso WB, Ferraro MJ, Hardy DJ, Knapp CC, McDougal LK, Reller LB, Sader HS, Shortridge D, Skov R, Weinstein MP, Zimmer BL, Patel JB. 2007. Detection of inducible clindamycin resistance in staphylococci by broth microdilution using erythromycin-clindamycin combination wells. J Clin Microbiol 42:39543957.
8. Swenson JM, Patel JB, Jorgensen JH. 2013. Special phenotypic methods for detecting antibacterial resistance, p 1155–1179. In Versalovic J, Carroll KC, Funke G, Jorgensen JH, Landry ML, Warnock DW (ed), Manual of Clinical Microbiology, 10th ed. ASM Press, Washington, DC.

Tables

Generic image for table
Quick reference list to screen for inducible clindamycin resistancea

Quick reference list to screen for inducible clindamycin resistance

Citation: Leber A. 2016. Detection of Inducible Clindamycin Resistance in spp., , and spp. Beta-Hemolytic Group, p 5.9.1-5.9.7. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch5.9

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