Evidence map›Paper›PMID 37400064›Full record

ArticleThe American journal of tropical medicine and hygiene2023

A Multicenter Experience of Inducible Clindamycin Resistance in Staphylococcus aureus Infection among 800 Egyptian Patients with or without Diabetes Mellitus.

Housam Ahmad Helmy, Mohamed Rashed AbdElhamed, Mohamed I Youssef, Houssam M F El Zamek, Ahmed Kamal, Ahmed Abdelfattah, Hossam Shabana, Ahmed Abuamer, Galal Abdelhameed Aboufarrag, Amr Aly Elshormilisy and 19 more

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The American journal of tropical medicine and hygiene, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Molecules (Basel, Switzerland) · 2025
    Article
  2. Toxic Shock Syndrome: A Literature Review.Antibiotics (Basel, Switzerland) · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

29 authors at 9 institutions in 2 countries.

Housam Ahmad HelmyDepartment of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Menoufia, Egypt.
Mohamed Rashed AbdElhamedDepartment of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohamed I YoussefDepartment of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Houssam M F El ZamekDepartment of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ahmed KamalDepartment of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Menoufia, Egypt.
Ahmed AbdelfattahDepartment of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Menoufia, Egypt.
Hossam ShabanaDepartment of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ahmed AbuamerDepartment of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Menoufia, Egypt.
Galal Abdelhameed AboufarragDepartments of Hepatology, Gastroenterology, and Infectious Diseases, Al-Azhar University, Cairo, Egypt.
Amr Aly ElshormilisyDepartment of Internal Medicine, Faculty of Medicine, Helwan University, Cairo, Egypt.
Doaa ElwazzanDepartment of Tropical Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Sara A SaiedDepartment of Clinical Pathology, National Liver Institute, Menoufia University, Menoufia, Egypt.
Ashraf Yousif ElfertDepartment of Clinical Biochemistry, National Liver Institute, Menoufia University, Menoufia, Egypt.
Shimaa Y KamelDepartment of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Amal El SharnobyDepartment of Clinical Pathology, National Liver Institute, Menoufia University, Menoufia, Egypt.
Hendawy Abdel-Moety ZedanDepartment of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Basant Mostafa GabrDepartment of Microbiology and Immunology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Farag KhalilDepartment of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ismail Mohamed ElmancyDepartment of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Hesham El-Sayed LashinDepartment of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Hind S AboShabaanDepartment of Clinical Pathology, National Liver Institute, Menoufia University, Menoufia, Egypt.
Yousef NassarDepartment of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Safa Reyad Abd Elsalam ElfikyDepartment of Clinical Pharmacology, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt.
Sally Waheed ElkhadryDepartment of Epidemiology and Preventive Medicine, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt.
Mohamed A SakrDepartment of Medical Microbiology and Immunology, Faculty of Medicine, Suez University, Suez, Egypt.
Ashraf M EidDepartment of Gastroenterology, Hepatology and Infectious Diseases, Shebin El-Kom Teaching Hospital, Shebin El-Kom, Egypt.
Sobhy Elsayed KotbAl Jalila Children's Speciality Hospital, Dubai, United Arab Emirates.
Marwa M OmarDepartment of Clinical Pathology, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
Mohsen M El-KhayatDepartment of Tropical Medicine, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt.
Menoufia University · EGAl-Azhar University · EGAin Shams University · EGAlexandria University · EGAl Jalila Foundation · AEHelwan University · EGShebin Teaching Hospital · EGSuez University · EGTanta University · EG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Staphylococcus aureus causes a wide range of illnesses, from skin infections and persistent bone infections to life-threatening septicemia and endocarditis. Methicillin-resistant S. aureus (MRSA) is one of the most common bacteria that cause nosocomial and community-acquired infections. Clindamycin is one of the most effective treatments for several bacterial infections. Despite this, these infections may develop inducible clindamycin resistance during treatment, leading to treatment failure. This study determined the incidence of inducible clindamycin resistance among S. aureus clinical isolates. A total of 800 S. aureus strains were identified from clinical samples collected from several university hospitals in Egypt. All isolates were examined for the presence of MRSA using cefoxitin (30 μg) and the Kirby Bauer disk diffusion technique. The induction phenotypes of all 800 S. aureus strains were evaluated using the disk approximation test (D test), as recommended by the Clinical and Laboratory Standard Institute. Of the 800 strains of S. aureus, 540 (67.5%) were identified as MRSA and 260 (32.5%) were classified as methicillin-sensitive S. aureus (MSSA). In MRSA infections, clindamycin constitutive and inducible resistance was more frequent than in MSSA infections (27.8% versus 11.5% and 38.9% versus 15.4%, respectively). Clindamycin-sensitive strains were more prevalent in MSSA (53.8%) than in MRSA (20.4%) infections. In conclusion, the frequency of constitutive and inducible clindamycin resistance in MRSA isolates emphasizes the need to use the D test in routine antimicrobial susceptibility testing to evaluate clindamycin susceptibility, as the inducible resistance phenotype can inhibit the action of clindamycin and thus affect treatment efficacy.

Indexed as

Diabetes MellitusMethicillin-Resistant Staphylococcus aureusStaphylococcal InfectionsAnti-Bacterial AgentsClindamycinEgyptHospitals, UniversityHumansMicrobial Sensitivity TestsStaphylococcus aureusAnti-Bacterial AgentsClindamycin

Identifiers

PMID37400064
PMCPMC10397438
OpenAlexW4382937612

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.