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Journal of Clinical Microbiology, December 2007, p. 4018-4020, Vol. 45, No. 12
0095-1137/07/$08.00+0     doi:10.1128/JCM.01158-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Agar Dilution Method for Detection of Inducible Clindamycin Resistance in Staphylococcus spp.{triangledown}

Clarence J. Fernandes,1 Matthew V. N. O'Sullivan,1,2* Yongwei Cai,2,3 Fanrong Kong,2 Xianyu Zeng,2,4 Gwendolyn L. Gilbert,2 and George Kotsiou1

Department of Microbiology, Royal North Shore Hospital, Sydney, New South Wales, Australia,1 Centre for Infectious Diseases and Microbiology—Public Health, Institute of Clinical Pathology and Medical Research, Westmead, New South Wales, Australia,2 Department of Dermatology, Hangzhou Third People's Hospital, Hangzhou, Zhejiang Province, People's Republic of China,3 Department of Dermatology, Wuhan First Hospital, Wuhan, Hubei Province, People's Republic of China4

Received 9 June 2007/ Returned for modification 27 August 2007/ Accepted 8 October 2007

We describe the development and validation of an agar dilution method for the detection of inducible clindamycin resistance by using 227 previously characterized erythromycin-resistant, clindamycin-susceptible Staphylococcus sp. isolates. Mueller-Hinton agar with defibrinated horse blood containing a range of erythromycin concentrations (1 to 8 mg/liter) combined with clindamycin at 0.5 mg/liter was used to determine the optimal concentration that produced growth of inducible isolates while inhibiting that of isolates without the inducible phenotype. A concentration of clindamycin of 0.5 mg/liter with erythromycin at 1 mg/liter was the optimal combination for detection of inducible resistance and resulted in a sensitivity of 100% (95% confidence interval [CI], 97.9 to 100) and a specificity of 100% (95% CI, 93.0 to 100). Attention must be paid to ensuring that a sufficient inoculum has been used, since an inoculum below the standard 107 bacteria/ml may result in false-negative results. This method has been incorporated into routine use in our laboratory.

* Corresponding author. Mailing address: Centre for Infectious Diseases and Microbiology, Level 3, ICPMR, Westmead Hospital, P.O. Box 533, Wentworthville, 2145 New South Wales, Australia. Phone: (612) 98455973. Fax: (612) 98938659. E-mail: matthew.osullivan{at}swahs.health.nsw.gov.au

{triangledown} Published ahead of print on 17 October 2007.

Journal of Clinical Microbiology, December 2007, p. 4018-4020, Vol. 45, No. 12
0095-1137/07/$08.00+0     doi:10.1128/JCM.01158-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.





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