Fluhr J W, Gloor M, Dietz P, Höffler U
Hautklinik, Städt. Klinikum Karlsruhe, Germany.
Zentralbl Bakteriol. 1999 Feb;289(1):53-61. doi: 10.1016/s0934-8840(99)80123-6.
In the present study, MIC values of 6 antibiotics were determined for 70 Propionibacterium acnes and 13 P.granulosum strains from 71 untreated acne patients using the agar dilution method. The interpretation of in vitro results is difficult because there are only poor data about the concentrations of antibiotics achievable in the sebaceous gland infundibulum. Based on breakpoint concentrations according to DIN 58,944, no resistance was found against chlortetracycline, doxycycline, minocycline, and chloramphenicol. In contrast, 11% of the P.acnes and 31% of the P.granulosum strains were not susceptible in vitro to erythromycin at a breakpoint concentration of 4 micrograms/ml. The present study shows that these strains are not suppressed even at higher erythromycin concentrations up to 256 micrograms/ml. Data from the literature reporting ineffective treatment of patients carrying erythromycin-resistant P.acnes strains may be explained by our study. Concerning clindamycin, resistance was found in only 6.8% of P.acnes and in 0% of the P.granulosum strains. Since sensitivity was seen in 100% of the strains already at a concentration of 16 micrograms/ml, a therapeutic effect may be possible.
在本研究中，采用琼脂稀释法对71例未经治疗的痤疮患者的70株痤疮丙酸杆菌和13株颗粒丙酸杆菌测定了6种抗生素的最低抑菌浓度（MIC）值。体外结果的解读很困难，因为关于皮脂腺漏斗部可达到的抗生素浓度的数据很少。根据德国标准DIN 58944的断点浓度，未发现对金霉素、强力霉素、米诺环素和氯霉素有耐药性。相比之下，在断点浓度为4微克/毫升时，11%的痤疮丙酸杆菌菌株和31%的颗粒丙酸杆菌菌株在体外对红霉素不敏感。本研究表明，即使红霉素浓度高达256微克/毫升，这些菌株也不会被抑制。文献中报道携带对红霉素耐药的痤疮丙酸杆菌菌株的患者治疗无效的数据可能可以用我们的研究来解释。关于克林霉素，仅在6.8%的痤疮丙酸杆菌菌株中发现耐药性，在颗粒丙酸杆菌菌株中未发现耐药性。由于在16微克/毫升的浓度下100%的菌株都表现出敏感性，因此可能有治疗效果。
