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Presencia de cepas de Staphylococcus spp. meticilino resistentes con resistencia inducible a la clindamicina de pacientes hospitalizados en el "Hospital Vicente Corral Mososo (HVCM)"

Abstract:

Background:Staphylococcus spp. infection resistant to methicillin has increased worldwide. This tendency is the consequence of bacteria developing new resistance mechanisms together with the indiscriminate use of antibiotics by the population. Although clindamycin is an alternative treatment against Staphylococcus spp, it is also likely to develop inducible resistance, which could lead to a therapeutic failure. Objective: To determine the existence of Staphylococcus spp. methicillin resistant strains with inducible resistance to clindamycin isolated from secretions, exudates and blood samples of patients in the "Vicente Corral Moscoso Hospital" from June to August 2016. Methods: A descriptive cross-sectional study was conducted. Strains from samples of secretions, exudates and blood from 122 hospitalized patients were included. The samples were tested for Staphylococcus spp. methicillin resistance with inducible resistance to clindamycin by applying a D-test. The test was performed according to the recommendations of Clinical and Laboratory Standards Institute (CLSI) 2016, reference strains were used for quality control. Results: In total, 122 strains of Staphylococcus spp. methicillin resistant were analyzed, of which 21 (17.21%) were Staphylococcus spp. methicillin resistant with inducible resistance to clindamycin. From the strains with inducible resistance to clindamycin, 13 (14.28%) were coagulase negative and 8 (25.81%) were coagulase positive. The distribution of the strains with inducible resistance to clindamycin according with the type of sample was: 13 (14.44%) originated from blood samples and 8 (28.57%) from secretions. According with the dependencies of the hospital: 6 (12.24%) samples correspond to Pediatrics, 6 (22.22%) to Internal Medicine, 5 (20.83%) to Neonatology and 4 (30.77%) to Surgery. Conclusions: This study provides information on the distribution of induced resistance to clindamycin in Staphylococcus spp. methicillin resistant. The last could be used as a basis for further research. Currently, in Ecuador, there is not much research on this topic with epidemiological significance.