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Authors’ response
*For correspondence: Ds_chitnis@rediffmail.com
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We thank V. Anil Kumar for his observations on our paper. We offer the following clarifications:
(i) Cefoxitin is expected to give higher sensitivity and specificity than oxacillin for the detection of MRSA. The reference quoted by Anil Kumar is based on the isolates having borderline oxacillin MIC. Our isolates could be having higher MIC for the two drugs.
(ii) We agree that inducible sensitive to clindamycin is an important issue and we have not included the data on inducible clindamycin resistance.
(iii) Resistance to ampicillin (67.67%) described in the Table was based on CLSI guidelines. However, some of the isolates showing intermediate level susceptibility were not included as resistant and could be the reason for the discrepancy.
(iv) We do agree when the organism is labelled as MRSA, all beta lactams are to be considered as resistant despite in vitro susceptibility to some of the beta lactam.
(v) The study includes data of 2008 as well, and the CLSI guidelines appeared later in 2009. The emphasis on MIC for vancomycin was hence given in our study.
(vi) The study did not include high level aminolycoside resistance and this could be a limitation of the study.
(vii) We accept that vancomycin MIC < 2 µg /ml is considered as susceptible and MIC 3 µg /ml should have been taken up as reduced susceptibility.
