inducible clindamycin resistance in clinical isolates of staphylococcus aureus due to erm genes, iran.

background and objectives: resistance to macrolide can be mediated by erm and msra genes in staphylococcus aureus . there are the evidences that show erm genes may be causative agent of inducible or constitutive resistance. the aim of this study was to investigate the incidence of inducible clindamycin resistance and determine the most frequency of erm and msr a genes among s. aureus isolates. materials and methods: in this study a total of 124 non duplicated clinical isolates of s. aureus were tested with disk diffusion method. all isolates were tested by pcr for mec a, erm a, erm b, erm c and msr a genes. results: according to pcr results, 48.4% had mec a gene and 51.6% were mec a negative. by phenotypic d-test method,32.3% revealed inducible resistance and recorded as d and d+. sensitive and constitutive phenotypes were found in 54.8% and 12.9% of isolates respectively. inducible clindamycin resistance was more prevalent in mrsa (29%) than mssa isolates (2.4%). among studied erm genes, the most frequency genes were erm a and erm c with 41.1% and 17.7% respectively. three isolates of them had d phenotype, while the pcr results of erm genes were negative. all isolates were negative for erm b or msr a genes. conclusion: since s. aureus isolates with inducible resistance may mutate and change to constitutive resistance, to prevent treatment failure, we suggest that inducible resistance test be performed on erythromycin resistant/clindamycin sensitive isolates.