Abstract
Propionibacterium acnes has been implicated in the development of acne vulgaris. Rampant use of topical and systemic antibiotics for acne vulgaris has led to resistance due to selective pressure. This study aimed to determine antibiotic resistance of P. acnes. A total of 102 samples were collected from acne lesions and cultured onto sheep's blood agar and brain-heart infusion agar supplemented with 5 g/L glucose and 2 mg/L furazolidone) (BHIg) under aerobic and anaerobic conditions. Species identification was done by conventional methods and the VITEK2 Compact system. The isolates were tested for penicillin, erythromycin, clindamycin, ciprofloxacin, nadifloxacin, and tetracycline by E-test, and minimum inhibitory concentration (MIC) of minocycline was determined by agar dilution on BHIg. MIC results were interpreted as per EUCAST (European Committee on Antimicrobial Susceptibility Testing) and CLSI (Clinical Laboratory Standards Institute) guidelines. P. acnes was the most common anaerobe (66%) isolated. Resistance rates using EUCAST and CLSI breakpoints were 10.6% and 6.1%, 7.6% and 0%, 7.8% and 0% for erythromycin, clindamycin, and minocycline, respectively. Tetracycline resistance was observed in 9.2% isolates irrespective of the interpretative criteria used. MIC50 and MIC90 values for nadifloxacin (0.25 and 1 µg/mL) were found to be twofold lower than those for ciprofloxacin (0.5 and 1 µg/mL). Similarly, MIC50 and MIC90 values for minocycline (0.125 and 0.5 µg/mL) were also two- to threefold lower than those for tetracycline (0.38 and 1 µg/mL). To the best of our knowledge, this is the first study focusing on P. acnes resistance from India.
Highlights
Propionibacterium acnes has been implicated in the development of acne vulgaris
Pathogenesis of acne is a complex interplay of inflammation, hyperkeratinisation of the sebaceous duct, high sensitivity to circulating androgens, and bacterial colonization [2]. Topical antibiotics such as erythromycin, clindamycin, and tetracycline are routinely used for long-term treatment of acne vulgaris, which exerts considerable selective pressure for the development of drug resistance [3]
This study was undertaken to examine the bacteriological profile of acne vulgaris and to ascertain its antimicrobial resistance patterns
Summary
Propionibacterium acnes has been implicated in the development of acne vulgaris. Rampant use of topical and systemic antibiotics for acne vulgaris has led to resistance due to selective pressure. The isolates were tested for penicillin, erythromycin, clindamycin, ciprofloxacin, nadifloxacin, and tetracycline by E-test, and minimum inhibitory concentration (MIC) of minocycline was determined by agar dilution on BHIg. MIC results were interpreted as per EUCAST (European Committee on Antimicrobial Susceptibility Testing) and CLSI (Clinical Laboratory Standards Institute) guidelines. Acne vulgaris is a chronic inflammatory disorder of pilosebaceous follicles that affects more than 85% of adolescents and young adults [1]. Pathogenesis of acne is a complex interplay of inflammation, hyperkeratinisation of the sebaceous duct, high sensitivity to circulating androgens, and bacterial colonization [2]. Topical antibiotics such as erythromycin, clindamycin, and tetracycline are routinely used for long-term treatment of acne vulgaris, which exerts considerable selective pressure for the development of drug resistance [3]. This study was undertaken to examine the bacteriological profile of acne vulgaris and to ascertain its antimicrobial resistance patterns
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