The prevalence and drug sensitivity of Propionibacterium acnes isolated from acne lesions

Agata Pruss, Paweł Kwiatkowski, Helena Masiuk, Stefania Giedrys-Kalemba

Abstract


ABSTRACT

Introduction: Propionibacterium acnes is one of many pathogens causing the formation of lesions in acne vulgaris, the most common chronic disease of the skin. It affects most adolescents, but can also occur in newborns, and persists in adults. Acne lesions usually occur around the sebaceous glands on the skin of the face, back and chest. Increased resistance of P. acnes to topical antibiotics is a serious medical problem.

The aim of the study was to determine the frequency of P. acnes in patients with acne depending on age and sex, and to evaluate drug susceptibility of the isolated strains.

Materials and methods: We analyzed the results of tests performed in 470 outpatients with acne at the age of 9–59 years. The material was a discharge containing pus taken from inflammatory changes of the face (64.3%), back (7.6%) and chest (28.1%). Samples were cultured in anaerobic conditions on Schaedler Agar. The strains were tested for susceptibility to erythromycin, clindamycin, tetracycline and doxycycline, according to the EUCAST standards.

Results: Positive cultures for P. acnes were found in 84.0% of patients. The highest proportion of positive culture was observed in the age group 21–30 years old (91.0%) and in >50 years (88.2%), the lowest in patients aged 31–40 (78.2%). P. acnes was isolated more often in men (86.1%) than in women (81.7%). All isolates showed sensitivity to doxycycline, and only 1.5% were resistant to tetracycline. A statistically significant (p ≤ 0.05) increase of resistance to erythromycin and clindamycin, from 29.6% in 2010 to 48.7% in 2014, was observed.

Conclusions: Acne lesions are increasingly observed in adults >21 years old. The prevalence of acne in women and men is comparable. P. acnes strains show good sensitivity to tetracyclines, but the increased resistance to erythromycin and clindamycin is alarming.

Keywords


Propionibacterium acnes; drug susceptibility; acne

Full Text:

PDF (Język Polski)

References


Braun-Falco O, Plewig G, Wolff HH, Burdgdorf WHC. Dermatologia. Lublin: Wyd. Czelej; 2004.

Plewig G, Kligman AM. Acne and rosacea. Berlin: Wyd. Springer; 1993.

Adamski Z, Kaszuba A. Dermatologia dla kosmetologów. Wrocław: Wyd. Elsevier Urban & Partner; 2010. p. 54-8.

Gollnick H, Cunliffe W, Berson D, Dreno B, Finlay A, Leyden JJ, et al. Management of acne: a report from a Global Alliance to Improve Outcomes in Acne. J Am Acad Dermatol 2003;49:S1-37.

Krasowska D. Trądzik. Diagnostyka i leczenie. Lublin: Wyd. Czelej; 2009. p. 115-70.

Simonart T, Dramaix M. Treatment of acne with topical antibiotics: lessons from clinical studies. Br J Dermatol 2005;153:395-403.

European Committee on Antimicrobial Susceptibility Testing. Breakpoints tables for interpretation of MICs and zones diameters. Version 5.0, 2015. http://www.eucast.org (28.03.2017).

Jeremy AH, Holland DB, Roberts SG, Thomson KF, Cunliffe WJ. Inflammatory events are involved in acne lesion initiation. J Invest Dermatol 2003;121:20-7.

Tałasiewicz K, Ołdakowska A, Szczerkowska-Dobosz A. Evaluation of knowledge about acne vulgaris among a selected population of adolescents of Tricity schools. Post Derm Alergol 2012;29(6):417-20.

Szepietowski J, Kapińska-Mrowiecka M, Kaszuba A, Langner A, Placek W, Wolska H, et al. Trądzik zwyczajny: patogeneza i leczenie. Konsensus Polskiego Towarzystwa Dermatologicznego. Przegl Dermatol 2012;99:649-73.

Goodman GJ. Patofizjologia blizn potrądzikowych – krótki opis mechanizmu ich powstawania. Dermatol Estet 2002;1:22-8.

Mendoza N, Hernandez PO, Tyring SK, Haitz KA, Motta A. Antimicrobial susceptibility of Propionibacterium acnes isolates from acne patients in Colombia. Int J Dermatol 2013;52:688-92.

Poli F, Dreno B, Verschoore M. An epidemiological study of acne in female adults: results of a survey conducted in France. J Eur Acad Dermatol Venereol 2001;15:541-5.

Khunger N, Kumar C. A clinico-epidemiological study of adult acne: is it different from adolescent acne? Indian J Dermatol Venereol Leprol 2012;78:335-41.

Goulden V, Stables GI, Cunliffe WJ. Prevalence of facial acne in adults. J Am Acad Dermatol 1999;41:557-80.

Collier CN, Harper JC, Cafardi JA, Cantrell WC, Wang W, Foster KW, et al. The prevalence of acne in adults 20 years and older. J Am Acad Dermatol 2008;58:56-9.

McConnell RC, Fleischer AB Jr, Williford PM, Feldman SR. Most topical tretinoin treatment is for acne vulgaris through the age of 44 years: an analysis of the National Ambulatory Medical Care Survey, 1990–1994. J Am Acad Dermatol 1998;38:221-6.

Dumont-Wallon G, Dréno B. Specificity of acne in women older than 25 years. Presse Med 2008;37:585-91.

Rivera R, Guerra A. Management of acne in women over 25 years of age. Actas Dermosifiliogr 2009;100:33-7.

Szczurek P, Kamińska-Winciorek G, Śpiewak R. Częstość występowania trądziku późnego oraz jego wpływ na jakość życia młodych kobiet. Estetol Med Kosmetol 2012;2(2):58-62. doi: 10.14320/EMK.2012.012.

Nast A, Dréno B, Bettoli V, Degitz K, Erdmann R, Finlay AY, et al. European evidence-based (S3) guidelines for the treatment of acne. J Eur Acad Dermatol Venereol 2012;Suppl 1:1-29.

Leyden JJ, McGinley KJ, Cavalieri S, Webster GF, Mills OH, Kligman AM. Propionibacterium acnes resistance to antibiotics in acne patients. J Am Acad Dermatol 1983;8:41-5.

Dreno B, Thiboutot D, Golnick H, Bettoli V, Kang S, Leyden JJ, et al. Antibiotic stewardship in dermatology: limiting antibiotic use in acne. Eur J Dermatol 2014;24(3):330-4.

Bowe WP. Antibiotic resistance and acne: where we stand and what the future holds. J Drugs Dermatol 2014;13(6):66-70.

Luk NM, Hui M, Lee HC, Fu LH, Liu ZH, Lam LY, et al. Antibiotic-resistant Propionibacterium acnes among acne patients in a regional skin centre in Hong Kong. J Eur Acad Dermatol Venereol 2013;27:31-6.

Song M, Seo SH, Ko HC, Oh CK, Kwon KS, Chang CL, et al. Antibiotic susceptibility of Propionibacterium acnes isolated from acne vulgaris in Korea. J Dermatol 2011;38:667-73.

Coates P, Vyakrnam S, Eady EA, Jones CE, Cove JH, Cunliffe WJ. Prevalence of antibiotic-resistant propionibacteria on the skin of acne patients: 10-year surveillance data and snapshot distribution study. Br J Dermatol 2002;146:840-8.

Lomholt HB, Kilian M. Clonality and anatomic distribution on the skin of antibiotic resistant and sensitive Propionibacterium acnes. Acta Derm Venereol 2014;94:534-8.

Thiboutot D, Gollnick H, Bettoli V, Dréno B, Kang S, Leyden JJ, et al. New insights into the management of acne: an update from the Global Alliance to Improve Outcomes in Acne group. J Am Acad Dermatol 2009;60:S1-50.

Eady AE, Cove JH, Layton AM. Is antibiotic resistance is cutaneous propionibacteria clinically relevant?: implications of resistance for acne patients and prescribers. Am J Clin Dermatol 2003;4:813-31.




DOI: https://doi.org/10.21164/pomjlifesci.442

Copyright (c) 2018 Agata Pruss, Paweł Kwiatkowski, Helena Masiuk, Stefania Giedrys-Kalemba

License URL: https://creativecommons.org/licenses/by-nc-nd/3.0/pl/