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Journal of Clinical Microbiology, December 2007, p. 3954-3957, Vol. 45, No. 12
0095-1137/07/$08.00+0     doi:10.1128/JCM.01501-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Detection of Inducible Clindamycin Resistance in Staphylococci by Broth Microdilution Using Erythromycin-Clindamycin Combination Wells{triangledown}

Jana M. Swenson,1* William B. Brasso,2 Mary Jane Ferraro,3 Dwight J. Hardy,4 Cynthia C. Knapp,5 Linda K. McDougal,1 L. Barth Reller,6 Helio S. Sader,7 Dee Shortridge,8 Robert Skov,9 Melvin P. Weinstein,10 Barbara L. Zimmer,11 and Jean B. Patel1

Antimicrobial Resistance Team, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30333,1 BD Diagnostic Systems, Sparks, Maryland 21152,2 Massachusetts General Hospital, Boston, Massachusetts 02114,3 University of Rochester Medical Center Hospital, Rochester, New York 14642,4 Trek Diagnostic Systems, Cleveland, Ohio 44131,5 Duke University Hospital, Durham, North Carolina 27710,6 JMI Laboratories, North Liberty, Iowa 52317,7 BioMérieux, Inc., Hazelwood, Missouri 63042,8 Statens Serum Institut, Copenhagen, Denmark 2300,9 Robert Wood Johnson Medical School, New Brunswick, New Jersey 08903,10 Dade Behring MicroScan, Inc., West Sacramento, California 95691,11

Received 26 July 2007/ Returned for modification 11 September 2007/ Accepted 8 October 2007

A study conducted by 11 laboratories investigated the ability of four combinations of erythromycin (ERY) and clindamycin (CC) (ERY and CC at 4 and 0.5, 6 and 1, 8 and 1.5, and 0.5 and 2 µg/ml) in a single well of a broth microdilution panel to predict the presence of inducible CC resistance. Each laboratory tested approximately 30 Staphylococcus aureus isolates and 20 coagulase-negative staphylococcus (CoNS) isolates in a panel using cation-adjusted Mueller-Hinton broth from three different manufacturers. Only the strains resistant to ERY and those susceptible or intermediate to CC were included in the analysis (S. aureus, n = 333; CoNS, n = 97). Results of the D-zone test were used as the gold standard. After an 18-h incubation, the combination of 4 µg/ml ERY and 0.5 µg/ml CC performed the best, with 98 to 100% sensitivity and 100% specificity for both organism groups. After a 24-h incubation, the ERY-CC combinations of 4 and 0.5, 6 and 1, and 8 and 1.5 µg/ml correlated well with the D-zone test.

* Corresponding author. Mailing address: Antimicrobial Resistance Team, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Mailstop G08, 1600 Clifton Rd., Atlanta, GA 30333. Phone: (404) 639-0196. Fax: (404) 639-1381. E-mail: jms1{at}cdc.gov

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

Journal of Clinical Microbiology, December 2007, p. 3954-3957, Vol. 45, No. 12
0095-1137/07/$08.00+0     doi:10.1128/JCM.01501-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.





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