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1 SPSS SA

2 CLSI erm msr PCR (MLSB) SrRNA MLSB Constitutive=cMLSB Vandana B Inducible=iMLSB mrna B MLSB mrna D B CDC Efflux pump

3 TAB/OXO.1 MHA Merck MAST MHA D S. aureus ATCC S. aureus ATCC MAST A SPSS DNase MAST MHA Mannitol salt agar MuellerHinton agar plate

4 P= P= (DTest) P= SA B cmlsb imlsb SA

5 SA B Kader Fielbelkorn imlsb SA SA SA Gadepalli

6 1 Ray C, Ryan KJ. Sherris Medical Microbiology: An Introduction to Infectious Diseases. 4th ed. New York: McGraw2 Fiebelkorn KR, Crawford SA, McElmeel ML, Jorgensen JH. Practical disk diffusion method for detection of inducible clindamycin resistance in Staphylococcus aureus and coagulasenegative staphylococci. J Clin Microbiol Ciraj AM, Vinod P, Sreejith G, Rajani K. Inducible clindamycin resistance among clinical isolates of Staphylococci. Indian J Pathol Microbiol Bouchami O, Achour W, Ben Hassen A. Prevalence of resistance phenotypes and genotypes to macrolide, lincosamide and streptogramin antibiotics in Grampositive cocci isolated in Tunisian Bone Marrow Transplant Center. Pathol Biol (Par Mallick Sk, Basak S, Bose S. Inducible clindamycin resistance in Staphylococcus aureus a therapeutic challenge. Journal of Clinical and Diagnostic research. (3): Leclercq R. Mechanisms of resistance to macrolides and lincosamides: nature of the resistance elements and their clinical implications. Clin Infect Dis Mohapatra TM, Shrestha B, Pokhrel BM. Constitutive and inducible clindamycin resistance in Staphylococcus aureus and their association with methicillinresistant S. aureus (): experience from a tertiary care hospital in Nepal. Int J Antimicrob Agents Pal N, Sharma B, Sharma R, Vyas L. Detection of inducible clindamycin resistance among Staphylococcal isolates O'Sullivan MV, Cai Y, Kong F, Zeng X, Gilbert GL. Influence of disk separation distance on accuracy of the disk approximation test for detection of inducible clindamycin resistance in Staphylococcus spp. J Clin Microbiol. 44(11): V, Datta P, Rani H, Chander J. Inducible clindamycin resistance in Staphylococcus aureus: a study from Vandana K, Singh J, Chiranjay M, Bairy I. Inducible Clindamycin Resistance in Staphylococcus aureus: Reason for Siberry GK, Tekle T, Carroll K, Dick J. Failure of clindamycin treatment of methicillinresistant Staphylococcus Bartlett JG. Methicillinst 14 Weigelt JA.. 1 ed. USA: Informa Healthcare 55.

7 15 Ajantha GS, Kulkarni RD, Shetty J, Shubhada C, Jain P. Phenotypic detection of inducible clindamycin resistance among Staphylococcus aureus isolates by using the lower limit of recommended interdisk distance. Indian J Pathol Rahbar M, Hajia M. Inducible clindamycin resistance in Staphylococcus aureus: a crosssectional report. Pak J Biol Kader AA, Kumar A, Krishna A. Induction of clindamycin resistance in erythromycinresistant, clindamycin susceptible and methicillin Steward CD, Raney PM, Morrell AK, Williams PP, McDougal LK, Jevitt L, et al. Testing for induction of clindamycin resistance in erythromycin Delialioglu N, Aslan G, Ozturk C, Baki V, Sen S, Emekdas G. Inducible clindamycin resistance in staphylococci isolated fro Gadepalli R, Dhawan B, Mohanty S, Kapil A, Das BK, Chaudhry R. Inducible clindamycin resistance in clinical 73.

8 Abstract Original Article Prevalence and characteristics of erythromycin and clindamycin resistance in nasal carriers of Staphylococcus aureus of hospital origin, Kermanshah, 2009 P. Mohajeri1, B. Izadi2, M. Rezaie3, B. Falahi4 Background and Aim: Due to the role of spreading infections in hospitals, drug resistant Staphylococcus aureus nasal carriers have always been considered. Clindamycin is one of the effective drugs against the bacteria, but some isolates have acquired induced resistance. This study was preformed to investigate the prevalence and characteristics of resistant isolates in nasal carriers of hospital origin, in Imam Reza Hospital, as the largest hospital in Kermanshah province. Materials and Methods: This crosssectional study was performed on the patients which their nasal samples were positive for Staphylococcus aureus after hospitalization, in the year Sensitivity of the isolates to erythromycin and clindamycin was determined. Induced, constitutive resistance and phenotype were evaluated by. Data were analyzed by means of SPSS version 16 and chisquare test at the significant level of Results: Among 1269 admitted patients, 210 (16.5%) were hospital acquirednasal carriers for the bacteria. The frequency of resistant isolates to erythromycin and clindamycin was 41.5% and 23.3%, respectively. The induced, constitutive and phenotype were 10%, 23.3% and 8.6% of isolates, respectively. A significant difference between (19.5%) and SA (3.9%) isolates with induced resistance was seen (P=0.001). Conclusion: Carrier patients of the resistant variants of Staphylococcus aureus are always a serious threat to their own health and others. Regarding the frequency of induced resistance to clindamycin, screening Staphylococcus aureus isolates in this regard, seems to be essential. Key Words: Induced resistance, Staphylococcus aureus, Clindamycin, Nasal carrier Journal of Birjand University of Medical Sciences. 2011; 18(1): 3239 Received: February 4, Last Revised: January 16, 2011 Accepted: January 18, 2011 Corresponding Author, Assistant Professor, Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran p_mohajeri@yahoo.com 2 Assistant Professor, Department of Pathology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran 3 Assistant Professor, Departments of Biostatic, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran 4 Medicine Student, Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran

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