title: Detection of inducible clindamycin resistance in staphylococci by disk diffusion induction test.
abstract: OBJECTIVE
  To detect inducible clindamycin (CL) resistance in staphylococci by disk diffusion induction test (D-test).
  
  
  METHODS
  One thousand one hundred eighty clinical isolates of staphylococci were tested for inducible CL resistance by placing erythromycin (E) disk and clindamycin disk 12 mm apart (edge to edge) on Mueller-Hinton agar plate inoculated with staphylococci. The flattening of CL zone (D-shaped zone) near E disk indicated an inducible CL resistance was observed after 18-24 h of incubation.
  
  
  RESULTS
  Inducible CL resistance was detected in 9.9% of staphylococci isolates. It was found in methicillin-resistant Staphylococcus aureus (MRSA) more than methicillin-sensitive Staphylococcus aureus (MSSA) and coagulase-negative staphylococci (CoNS) 35.9%, 4.7%, and 5.5%, respectively.
  
  
  CONCLUSIONS
  To avoid misinterpretation of CL result, D-test is recommended for routine detecting of inducible CL resistance in staphylococci. It provides the confident laboratory report of CL as resistant (D-shaped zone positive) or as susceptible (D-shaped zone negative) particular for E resistant isolates.
authors.affiliation: Microbiology Unit, Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand. jsureera@medicine.psu.ac.th
authors.forename: Sureerat
authors.initials: S
authors.lastname: Chelae
authors.forename: Varaporn
authors.initials: V
authors.lastname: Laohaprertthisarn
authors.forename: Manthana
authors.initials: M
authors.lastname: Phengmak
authors.forename: Urairat
authors.initials: U
authors.lastname: Kongmuang
authors.forename: Sineenart
authors.initials: S
authors.lastname: Kalnauwakul
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002981:Clindamycin / Q000494:pharmacology*; D052978:Disk Diffusion Antimicrobial Tests / Q000379:methods; D004352:Drug Resistance, Microbial; D006801:Humans; D013210:Staphylococcus / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents; D002981:Clindamycin