In vitro antimicrobial susceptibility patterns of Propionibacterium acnes isolated from patients with acne vulgaris (original) (raw)
Related papers
Antibiotic susceptibility of Propionibacterium acnes isolated from acne vulgaris in Korea
The Journal of Dermatology, 2010
Propionibacterium acnes plays an important role in the development of acne, and inflammatory lesions are improved by antibiotics. Long-term use of antibiotics may result in development of resistant strains and treatment failure. The aim of the present study was to investigate the isolation rate of P. acnes and to evaluate its antibiotic susceptibility to widely used antibiotics in acne in Korea. Among 46 patients, 31 P. acnes strains were cultured. Isolated P. acnes was measured for minimum inhibitory concentration (MIC) of tetracycline, doxycycline, minocycline, erythromycin and clindamycin using an Epsilometer test. Age, disease duration and previous history of antibiotic therapy for acne were compared in relation to the MIC. The mean MIC of tetracycline, minocyclines, doxycycline, clindamycin and erythromycin were all below the breakpoint of antibiotic resistance. The patients with acne vulgaris with disease duration of more than 2 years documented higher MIC values in doxycycline, erythromycin, and clindamycin than those of less than 2 years. The patients who were previously treated with topical or systemic antibiotics showed higher MIC in doxycycline. Antibiotic resistance of P. acnes is still low in Korea, but at this point, there is an increasing trend of MIC. Caution and acknowledgement of increased risk of antibiotic resistant P. acnes should be advised in acne antibiotic treatment to minimize and avoid the emergence of the resistant strain.
2006
Propionibacterium acnes (P. acnes) is an anaerobic, Gram-positive bacterium that belongs to the normal microflora. The skin is the major habitat but it can also be found in other body regions. P. acnes plays an important role in the pathogenesis of acne vulgaris. The general perception is that P. acnes is a microorganism with low virulence, but during the last years, the prevalence of severe, life-threatening infections caused by P. acnes has increased, especially in immuno-compromised patients and in those with prosthetic devices. Long courses of antibiotics have been a mainstay of acne treatment. The consequence has been the development of antibiotic-resistant P. acnes. The aim of the present investigation was to perform a characterisation of P. acnes antibiotic-resistant clinical isolates collected from acne patients and various other diseases. The resistance pattern, genetic diversity and molecular resistance mechanisms have been studied. We have found that acne patients in Stockholm treated with antibiotics had a significantly higher risk of carrying resistant P. acnes strains, than acne patients who did not receive such a treatment. Furthermore, we have demonstrated that antimicrobial resistance has emerged among P. acnes strains isolated from different severe, lifethreatening infections in Europe. The prevalence of tetracycline resistant isolates was lower as compared to erythromycin and clindamycin resistant isolates. The bacterial resistance in P. acnes isolates obtained from various diseases mirrors the situation with antimicrobials presently in use in different countries. We have developed a new pulsed-field gel electrophoresis protocol as typing method for P. acnes strains. Pulsed-field gel electrophoresis is a powerful tool in epidemiology for the determination of clonal identity of bacteria. We have demonstrated that antibiotic-resistant P. acnes population is polyclonal and that skin isolates do not represent a separate pulsed-field type when compared with the bacterial population from other sites than the skin. We have shown that an acne patient may be colonized with different P. acnes strains with various resistance phenotypes, suggesting that certain bacterial clones are more prone to acquire resistance against a specific antibiotic. The resistant strains from acne and other diseases showed well-known mutations in the 23S rRNA and 16S rRNA, but also new mechanisms of resistance have evolved. It is conceivable that mobile genetic elements carrying resistance genes have developed and can be transferred to other pathogenic bacteria. There is a complex relationship between antibiotic resistance and outcome in acne vulgaris. It is still an open question how much of the antibiotic efficacy in acne is due to the anti-propionibacterial or anti-inflammatory effect. Treatment with oral tetracycline combined with a topical retinoid proved to be a good clinical alternative to oral isotretinoin, regardless of the presence of antibiotic-resistant P. acnes on the skin. The resistance seems to move from the acne patients to the community. We have shown that carriage of resistant P. acnes isolates occurs, not only in acne patients and their close contacts, but also in the general population. Close contacts within families were found to carry the same clonal type of antibiotic-resistant P. acnes as acne patients. The cost of resistance may be ameliorated by compensatory mutations causing the stabilization of the antibiotic-resistant bacterial population. Efforts should be made in preventing the development of resistance and the accumulation of antibiotic resistant P. acnes strains.
Journal of the European Academy of Dermatology and Venereology, 2011
Background There has been no study on antibiotic-resistant Propionibacterium acnes in Hong Kong. Objective We investigated the prevalence and pattern of antibiotic-resistant P. acnes and to identify any associated factors for harbouring the resistant strains. Methods Culture and sensitivity testing of P. acnes to commonly used antibiotics were performed. Resistance to tetracycline was defined at a minimal inhibitory concentration (MIC) of 2 lg ⁄ mL or more; erythromycin at an MIC of 0.5 lg ⁄ mL or more; clindamycin at an MIC of 0.25 lg ⁄ mL or more according to EUCAST. For breakpoints of doxycycline and minocycline, those with an MIC of 1 lg ⁄ mL or more were defined as resistant strains. Results Among the 111 specimens collected from 111 patients, 86 strains of P. acnes were recovered, one from each specimen. Twenty-five specimens had no growth. Forty-seven (54.8%) strains were found to be resistant to one or more antibiotics. Forty-six (53.5%), 18 (20.9%), 14 (16.3%), 14(16.3%) and 14 (16.3%) strains were resistant to clindamycin (CL), erythromycin (EM), tetracycline (TET), doxycycline (DOX) and minocycline (MR) respectively. Ten strains (11.6%) had cross resistance between the MLS antibiotics (erythromycin or clindamycin), one strain (1.2%) had cross resistance among the cyclines and 14 strains (16.4%) had cross resistance between the MLS and cycline antibiotics. Binary logistic regression showed an association between MLS antibiotic resistance with an increased age whereas cycline resistance was associated with the duration of treatment. Conclusions Antibiotic-resistant P. acnes is prevalent in Hong Kong. Dermatologists should be more vigilant in prescribing antibiotics for acne patients.
European surveillance study on the antibiotic susceptibility of Propionibacterium acnes
Clinical Microbiology and Infection, 2005
Propionibacterium acnes strains are recovered from infections linked to surgical procedures, foreign bodies and septicaemia. This study investigated the antibiotic susceptibility patterns of P. acnes isolates from different systemic infections and determined the genomic diversity among resistant P. acnes isolates with low-frequency restriction analysis of chromosomal DNA by pulsed-field gel electrophoresis (PFGE). In total, 304 P. acnes isolates from 13 laboratories in 13 European countries were tested against six antimicrobial agents by the NCCLS reference agar dilution method and the breakpoints recommended by the European Committee on Antimicrobial Susceptibility Testing. Blood isolates were encountered most frequently, followed by those from skin and soft tissue infections, and abdominal infections. Of the isolates examined, 2.6% were resistant to tetracycline, 15.1% to clindamycin, and 17.1% to erythromycin. No resistance was observed to linezolid, benzylpenicillin or vancomycin. There was considerable variation between countries in the proportion of resistant strains, ranging from 83% in Croatia and 60% in Italy to 0% in The Netherlands. Isolates from blood were predominant among the resistant isolates. Seventeen clones and 78 banding patterns were identified among the resistant isolates. It was concluded that antimicrobial resistance has now emerged among P. acnes isolates from systemic infections.
Anaerobe, 2005
Propionibacterium acnes (P. acnes) is an anaerobic, Gram-positive bacterium that belongs to the normal microflora. The skin is the major habitat but it can also be found in other body regions. P. acnes plays an important role in the pathogenesis of acne vulgaris. The general perception is that P. acnes is a microorganism with low virulence, but during the last years, the prevalence of severe, life-threatening infections caused by P. acnes has increased, especially in immuno-compromised patients and in those with prosthetic devices. Long courses of antibiotics have been a mainstay of acne treatment. The consequence has been the development of antibiotic-resistant P. acnes. The aim of the present investigation was to perform a characterisation of P. acnes antibiotic-resistant clinical isolates collected from acne patients and various other diseases. The resistance pattern, genetic diversity and molecular resistance mechanisms have been studied. We have found that acne patients in Stockholm treated with antibiotics had a significantly higher risk of carrying resistant P. acnes strains, than acne patients who did not receive such a treatment. Furthermore, we have demonstrated that antimicrobial resistance has emerged among P. acnes strains isolated from different severe, lifethreatening infections in Europe. The prevalence of tetracycline resistant isolates was lower as compared to erythromycin and clindamycin resistant isolates. The bacterial resistance in P. acnes isolates obtained from various diseases mirrors the situation with antimicrobials presently in use in different countries. We have developed a new pulsed-field gel electrophoresis protocol as typing method for P. acnes strains. Pulsed-field gel electrophoresis is a powerful tool in epidemiology for the determination of clonal identity of bacteria. We have demonstrated that antibiotic-resistant P. acnes population is polyclonal and that skin isolates do not represent a separate pulsed-field type when compared with the bacterial population from other sites than the skin. We have shown that an acne patient may be colonized with different P. acnes strains with various resistance phenotypes, suggesting that certain bacterial clones are more prone to acquire resistance against a specific antibiotic. The resistant strains from acne and other diseases showed well-known mutations in the 23S rRNA and 16S rRNA, but also new mechanisms of resistance have evolved. It is conceivable that mobile genetic elements carrying resistance genes have developed and can be transferred to other pathogenic bacteria. There is a complex relationship between antibiotic resistance and outcome in acne vulgaris. It is still an open question how much of the antibiotic efficacy in acne is due to the anti-propionibacterial or anti-inflammatory effect. Treatment with oral tetracycline combined with a topical retinoid proved to be a good clinical alternative to oral isotretinoin, regardless of the presence of antibiotic-resistant P. acnes on the skin. The resistance seems to move from the acne patients to the community. We have shown that carriage of resistant P. acnes isolates occurs, not only in acne patients and their close contacts, but also in the general population. Close contacts within families were found to carry the same clonal type of antibiotic-resistant P. acnes as acne patients. The cost of resistance may be ameliorated by compensatory mutations causing the stabilization of the antibiotic-resistant bacterial population. Efforts should be made in preventing the development of resistance and the accumulation of antibiotic resistant P. acnes strains.
Anaerobe, 2004
The objective was to study the prevalence and antibiotic susceptibility patterns of Propionibacterium acnes strains isolated from patients with moderate to severe acne in Stockholm, Sweden and to determine the diversity of pulsed-field gel electrophoresis types among resistant P. acnes strains. One hundred antibiotic-treated patients and 30 non-antibiotic-treated patients with moderate to severe acne participated in the investigation. Facial, neck and trunk skin samples were taken with the agar gel technique. The susceptibility of P. acnes strains to tetracycline, erythromycin, clindamycin and trimethoprim-sulfamethoxazole was determined by the agar dilution method. The genomic profiles of the resistant strains were determined by pulsed-field gel electrophoresis. In the group of patients treated with antibiotics, resistant P. acnes strains were recovered in 37%, while in the non-antibiotic group of patients the incidence of resistant strains was 13%. Thus antibiotic-resistant P. acnes strains were significantly more often isolated from antibiotic-treated patients with moderate to severe acne than from non-antibiotic-treated patients (odds ratio, 3.8; P ¼ 0:01). There was a genetic diversity among the P. acnes strains. Forty-four different patterns of SpeI DNA digests were detected and two predominant clones were found. P. acnes strains exhibited different antibiotic susceptibility patterns and identical genotypes or vice versa. A person can be colonized with different strains with varying degrees of antibiotic resistance. The risk of increased resistance of P. acnes must be considered when treating acne patients with antibiotics, and especially long-term therapy should be avoided.
Australasian Journal of Dermatology, 2012
Background/Objectives: Antibiotic resistance in the community, including transfer between bacteria, is a growing concern for clinicians. Acne is commonly treated in general practice, sometimes with antibiotics. The aim of this study is to measure the rate of carriage of antibiotic resistant Propionibacterium acnes 10 years apart in general practice and the relationship of resistance to type of treatment, as well potential effects on other flora.