Department of Dermatology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey Department of Microbiology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey Dermatologist, Kırıkkale State Hospital, Kirikkale, Turkey Department of Microbiology, Faculty of Medicine, Resident, Süleyman Demirel University, Isparta, Turkey.
J Eur Acad Dermatol Venereol. 2013 Mar;27(3):332-6. doi: 10.1111/j.1468-3083.2011.04397.x. Epub 2012 Jan 13.
Although there are several studies about the alteration in skin flora, limited number of reports about changes in the microbial contents and their resistance profile of other body sites in patients treated with isotretinoin for acne vulgaris.
The aim of this study was to investigate the effects of systemic isotretinoin and antibiotic therapy on the microbial floras of oropharynx, nose and feces in acne patients.
Treatment groups of isotretinoin and antibiotics consisting of 20 and 15 patients, respectively were included. Microbiological culture samples were taken at baseline and once a month during 4-6 months of treatment period.
Difference in microbial flora throughout the treatment period was detected at least among one of all culture samples of 15 (75%) and 5 (33%) patients in isotretinoin and antibiotic groups. There was statistically significant difference between two groups in means of alteration of the microbial flora (P = 0.013). The difference was definitely observed among nasal cultures (65%) in isotretinoin group and fecal cultures (20%) in the other. Staphylococcus aureus colonization was prominent in the microbial floras of nose and oropharynx and 2 of 14 nasal isolates were detected to be methicilline resistant while Escherichia coli with extended spectrum beta lactamase activity was detected in fecal floras of patients in isotretinoin group.
Systemic isotretinoin and antibiotic treatments in acne patients precisely caused variations in the microbial floras of several sites of the body, while isotretinoin was commonly more responsible than antibiotics. Knowing that alterations in the microbial colonization of the flora regions may preceede infectious disease and bacterial resistance, treatment options and follow-up procedures in acne vulgaris should be carefully determined to reduce the risk of destruction of the microbial flora.
虽然有几项关于皮肤菌群改变的研究，但关于接受异维 A 酸治疗寻常痤疮的患者其他身体部位微生物含量及其耐药谱变化的报告数量有限。
本研究旨在调查全身异维 A 酸和抗生素治疗对寻常痤疮患者口咽、鼻腔和粪便微生物区系的影响。
纳入 20 名接受异维 A 酸治疗和 15 名接受抗生素治疗的患者。在治疗期间的 4-6 个月内，每月采集一次微生物培养样本。
至少有 15 名（75%）和 5 名（33%）患者的所有培养样本中，在整个治疗期间微生物菌群都发生了变化。两组之间的微生物菌群变化均值存在统计学差异（P=0.013）。异维 A 酸组鼻腔培养物（65%）和另一组粪便培养物（20%）之间的差异明显。金黄色葡萄球菌定植于鼻腔和口咽的微生物区系中，14 个鼻分离株中有 2 个被检测为耐甲氧西林，而对扩展谱β内酰胺酶活性的大肠埃希菌则存在于异维 A 酸组患者的粪便区系中。
系统性异维 A 酸和抗生素治疗确实会导致痤疮患者多个部位的微生物区系发生变化，而异维 A 酸比抗生素更常见。鉴于微生物定植区系的改变可能先于感染性疾病和细菌耐药性，因此在治疗寻常痤疮时应仔细确定治疗方案和随访程序，以降低破坏微生物区系的风险。
