Staphylococcus aureus with inducible clindamycin resistance and methicillin resistance in a tertiary hospital in Nepal
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Updated: Oct 8, 2025
Biosensor for Detection of Antibiotic Resistant Staphylococcus Bacteria
Published on: May 8, 2013
Devi Thapa1, Susil Pyakurel2, Sabita Thapa1
1Department of Microbiology, Kantipur College of Medical Science, Kathmandu, Nepal.
Background:
Staphylococcus aureus is a global public health issue in both community and hospital settings. Management of methicillin-resistant S. aureus (MRSA) infections are tough owing to its resistance to many antibiotics. Macrolide-lincosamide-streptogramin B (MLSB) antibiotics are commonly used for the management of MRSA. This study was aimed to determine the occurrence of inducible clindamycin- and methicillin-resistant S. aureus at a tertiary care hospital in Kathmandu, Nepal.
Methods:
A total of 1027 clinical samples were processed following standard laboratory procedures and antibiotic susceptibility testing of S. aureus was performed by disc diffusion method. MRSA isolates were detected phenotypically using cefoxitin disc, and inducible clindamycin resistance was detected phenotypically using the D-zone test.
Results:
Of 1027 samples, 321 (31.2%) were culture positive, of which 38 (11.8%) were S. aureus. All S. aureus isolates were susceptible to vancomycin, and 25 (67%) of S. aureus isolates were multidrug-resistant. Similarly, 15 (39.5%) of S. aureus were MRSA and 14 (36.5%) were inducible clindamycin-resistant phenotypes.
Conclusion:
Inducible clindamycin and methicillin resistance were common in S. aureus. This emphasizes that the methicillin resistance test and the D-zone test should be incorporated into the routine antibiotic susceptibility testing in hospital settings.
Insights
Inducible clindamycin resistance and methicillin-resistant Staphylococcus aureus (MRSA) are common in Nepal. Routine testing for these resistances is crucial for effective Staphylococcus aureus infection management.
Area of Science:
- Microbiology
- Infectious Diseases
- Clinical Science
Background:
- Staphylococcus aureus is a significant global health concern.
- Methicillin-resistant S. aureus (MRSA) poses treatment challenges due to antibiotic resistance.
- Macrolide-lincosamide-streptogramin B (MLSB) antibiotics are frequently used for MRSA infections.
Purpose of the Study:
- To determine the prevalence of inducible clindamycin resistance in S. aureus.
- To assess the occurrence of methicillin-resistant S. aureus (MRSA).
- To investigate antimicrobial resistance patterns in a tertiary care hospital in Kathmandu, Nepal.
Main Methods:
- Antibiotic susceptibility testing of 38 S. aureus isolates from 1027 clinical samples using the disc diffusion method.
- Phenotypic detection of MRSA using cefoxitin discs.
- Phenotypic identification of inducible clindamycin resistance via the D-zone test.
Main Results:
- Out of 321 S. aureus isolates, 15 (39.5%) were MRSA.
- 14 (36.5%) isolates exhibited inducible clindamycin resistance.
- All S. aureus isolates were susceptible to vancomycin; 67% were multidrug-resistant.
Conclusions:
- Inducible clindamycin resistance and MRSA are prevalent in S. aureus isolates.
- The methicillin resistance test and D-zone test are recommended for routine antibiotic susceptibility testing.
- This highlights the need for careful antibiotic selection in managing S. aureus infections.
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