Clindamycin (Cd) is one of the important alternative antibiotics in the therapy of Staphylococcus aureus, particularly in methicillin resistant Staphylococcus aureus (MRSA). Without the double-disk test, all the Staphylococcus aureus isolates with in- ducible Cd would have been misclassifed as Cd susceptible, resulting in an underes- timated Cd resistance rate. We report a Cd clinical failure where resistance developed on therapy in D-test-positive MRSA strains. The D-test identifes inducible resistance that might presage mutational Cd resistance which can be either constitutive or inducible. The present study was aimed to know the prevalence and phenotypic characterization of induced Cd resistance in MRSA isolates from hospital patients of various medical wards, surgical wards, diabetic care centres and intensive care units (ICU) of diferent corporate hospitals of Coastal Andhra Pradesh, South India. The specimens were collected from various body fuids and swabs of patients;- blood (n=29), urine (n=50), pus(n=45), nasal swabs (n=40), respiratory tract swabs (n=40), eye swabs (n=50), ear swabs (n=89), and skin infection swabs (n=80). These samples were tested for the presence of MRSA and screening was done by Oxacillin discs. Out of the 153 coagulase positive Staphylococcus aureus isolates, 82 were MRSA. Eryth- romycin (Ery) resistance was observed in 23 isolates which expressed Cd inhibitory activity and one isolate was resistant to both Cd and Ery. The present study showed high level of multidrug resistance among MRSA and high incidence of Ery induced Cd resistance is also observed. Hence, it is advisable to include inducible Cd resistance testing as a part of routine antibiotic susceptibility as it may be missed in routine antibiotic testing to avoid treatment failure.
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