Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan.
Department of Dermatology, Toranomon Hospital, Tokyo, Japan.
J Dermatol. 2017 Nov;44(11):1248-1254. doi: 10.1111/1346-8138.13913. Epub 2017 Jun 17.
The prevalence of antimicrobial-resistant Propionibacterium acnes strains isolated from acne patients has been increasing in Japan. Here, to estimate the current resistance rate, we tested antimicrobial susceptibility among P. acnes from acne patients having visited a specialized dermatology clinic between 2013 and 2015. Rates of resistance to macrolides and clindamycin were 44.3 (31/70) and 38.6% (27/70), respectively. erm(X), which confers high-level clindamycin resistance (minimum inhibitory concentration ≥256 μg/mL), was detected in six isolates, whereas no resistance determinants were identified in eight strains showing high-level resistance to clindamycin. Using single-locus sequence typing, the P. acnes isolates were classified into five clades (A, E, F, H and K), with all high-level clindamycin-resistant strains lacking known clindamycin resistance determinants being grouped together (in clade F). P. acnes isolates from patients previously treated with macrolides and clindamycin showed a macrolide resistance rate (55.3%) significantly higher than that of those from patients not having received these treatments (21.7%, P < 0.05). Furthermore, strains of clade F, which were very rarely isolated from healthy individuals, were more frequently recovered from patients with severe acne (40.0%) than those with mild acne (23.3%). Our data showed an increase in macrolide-resistant P. acnes prevalence in Japan due to the use of antimicrobial agents for acne treatment. Furthermore, we identified strains of specific phylogenetic groups frequently associated with severe acne patients.
在日本，从痤疮患者中分离出的耐抗生素痤疮丙酸杆菌（Propionibacterium acnes）菌株的流行率一直在上升。在这里，为了评估当前的耐药率，我们测试了 2013 年至 2015 年间在一家专门皮肤科诊所就诊的痤疮患者的痤疮丙酸杆菌对各种抗生素的敏感性。对大环内酯类和克林霉素的耐药率分别为 44.3%（31/70）和 38.6%（27/70）。 erm(X) 可导致高水平克林霉素耐药（最低抑菌浓度≥256μg/ml），在 6 株分离株中检测到，而在 8 株对克林霉素表现出高水平耐药的菌株中未鉴定出耐药决定因素。通过单基因座序列分型，将痤疮丙酸杆菌分离株分为五个群（A、E、F、H 和 K），所有高水平克林霉素耐药的菌株均属于缺乏已知克林霉素耐药决定因素的群（F 群）。先前接受大环内酯类和克林霉素治疗的患者的痤疮丙酸杆菌分离株对大环内酯类的耐药率（55.3%）明显高于未接受这些治疗的患者（21.7%，P<0.05）。此外，很少从健康个体中分离到的 F 群菌株更频繁地从严重痤疮患者（40.0%）中分离出来，而不是轻度痤疮患者（23.3%）。我们的数据显示，由于抗生素治疗痤疮的使用，日本大环内酯类耐药痤疮丙酸杆菌的流行率有所增加。此外，我们鉴定出与严重痤疮患者频繁相关的特定进化群的菌株。
