High rate of inducible clindamycin resistance in Staphylococcus aureus isolates--a multicenter study in Tokyo, Japan

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Antimicrobial Resistance

Background:

• Antibiotic resistance in Staphylococcus aureus (S. aureus) is a significant global health challenge.
• Community-acquired methicillin-resistant S. aureus (MRSA) infections are increasing, with clindamycin often used as empiric therapy.
• Understanding local rates of inducible clindamycin resistance is crucial for effective treatment strategies.

Purpose of the Study:

• To determine the incidence of inducible clindamycin resistance among S. aureus isolates in Tokyo, Japan.
• To assess the prevalence of this resistance mechanism in a major urban population.

Main Methods:

• A multicenter study involving adult and pediatric samples collected from January to December 2011.
• Analysis of 2341 S. aureus isolates from a university hospital and two pediatric hospitals.
• Testing for inducible clindamycin resistance in erythromycin-resistant and clindamycin-susceptible/intermediate isolates.

Main Results:

• A high incidence of 91% (n = 585) for inducible clindamycin resistance was observed.
• This rate is significantly higher than reported in many other countries.
• The study identified a substantial burden of this resistance in the sampled population.

Conclusions:

• Tokyo exhibits a very high rate of inducible clindamycin resistance in macrolide-resistant S. aureus.
• This finding has critical implications for the empiric use of clindamycin in this region.
• Further surveillance and updated treatment guidelines are warranted.