Comparison of Vitek 2 system and D-test for detection of inducible clindamycin resistance in Staphylococcus species in a tertiary care hospital: }an we rely on automation? | ||||
| Microbes and Infectious Diseases | ||||
| Articles in Press, Accepted Manuscript, Available Online from 03 July 2025 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mid.2025.373570.2676 | ||||
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| Authors | ||||
Deepa Devhare   ; Vrushali Thakar; Mahadevan Kumar ; Meera Modak ; Kishore Vadithya
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| Department of Microbiology, Bharati Vidyapeeth Medical College, Pune, India | ||||
| Abstract | ||||
| Background: Macrolides, lincosamides, and streptogramin B (MLSB) antibiotics act by inhibiting 50S ribosomal subunit mediated bacterial protein synthesis. Staphylococcus species exhibits resistance to MLSB antibiotics through msr (A)-mediated efflux and erm gene-mediated ribosomal modification. Clindamycin widely used for skin and soft tissue infections, due to its oral bioavailability, tissue penetration and low cost, especially against Staphylococcus species. If inducible Macrolides, lincosamides, and streptogramin B (iMLSB) goes undetected, then it can lead to therapy failure. Material and methods: This study evaluated the performance of the Vitek 2 compact system against the phenotypic D-test for detecting iMLSB in Staphylococcus isolates. All the clinical isolates of Staphylococcus species isolated during study period were included in the study. The isolates of Staphylococcus species which were resistant to erythromycin were subjected to D-test which was a gold standard test. Results: A total of 58 isolates of Staphylococcus species, were obtained during study perod. Of these Staphylococcus species, 34 isolates were S.aureus (58.62%) and 24 isolates were CONS (41.4%). Among CONS, Staphylococcus hemolyticus was the most common species (41.7%). Total 39 isolates of Staphylococcus species ( 67.24%) were resistant to erythromycin and were subjected to D-test. The iMLSB was present in 41.02% isolates of Staphylococcus species by D-test. Discrepancies were noted with Vitek 2 test which included one false-negative and one false-positive result giving a sensitivity of 93.75% and specificity of 95.65%. Conclusion: The study highlights the importance of confirming Vitek 2 results with the D-test to ensure accurate detection of iMLSB and guide effective treatment. | ||||
| Keywords | ||||
| automated system; phenotypic methods; iMLSB | ||||
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