Department of Pharmacology and Biomedical Sciences, Faculty of Pharmacy, Petra University, Amman, Jordan.
Consultant Dermatologist, private clinic, Amman, Jordan.
BMC Dermatol. 2020 Nov 17;20(1):17. doi: 10.1186/s12895-020-00108-9.
Antibiotics have been used for decades against Cutibacterium acnes (previously known as Propionibacterium acnes; C. acnes). Alarmingly, antibiotic resistance to this bacterium has become a worldwide problem in recent years. No studies are available on the antibiotic susceptibility patterns of C. acnes among Jordanian acne patients and how that is influenced by antibiotic use. This study aims to assess antibiotic resistance patterns of C. acnes clinical isolates and neighboring Gram-positive normal flora of the skin obtained from acne patients attending dermatology clinics in Amman -Jordan appraising the role of antibiotic consumption.
This is a cross-sectional study of acne patients presenting to selected dermatology outpatient clinics over a 6-month study period. Swabs obtained from inflamed lesions were cultured aerobically and anaerobically. Isolates were identified and screened for antibiotic susceptibility. In addition, all patients were asked to fill in a questionnaire that included questions about the history of antibiotic treatment.
C. acnes was isolated from lesions of 100 patients out of 115 participants included in this study. 73% of the isolates were resistant to erythromycin and 59% to clindamycin 37% to doxycycline, 36% to tetracycline, 31% to trimethoprim / sulfamethoxazole, 15% to levofloxacin, and 3% to minocycline. Multi drug resistance (MDR) in C. acnes isolates as well as Staphylococcus aureus (S. aureus) and Staphylococcus epidermidis (S. epidermidis) with a similar pattern of resistance were detected from the same patient in most cases. A pattern of higher resistance towards variable antibiotic was observed in patients previously treated with antibiotics for acne management.
The findings of this study demonstrate the distribution of antibiotic resistance of C. acnes towards used antibiotics and emphasizes the influence of antibiotic consumption on development of antibiotic resistance. The similar pattern of resistance between skin bacteria tested in this study highlights the genetic transfer of resistance between skin commensals including S. aureus and S. epidermidis hence promoting its circulation in the community.
几十年来，抗生素一直被用于治疗痤疮丙酸杆菌（以前称为丙酸痤疮杆菌；痤疮丙酸杆菌）。近年来，令人震惊的是，这种细菌对抗生素的耐药性已成为一个全球性问题。目前尚无关于约旦痤疮患者中痤疮丙酸杆菌抗生素药敏模式的研究，也没有研究表明抗生素的使用如何影响这种模式。本研究旨在评估从约旦皮肤科诊所就诊的痤疮患者的皮肤病变中分离出的痤疮丙酸杆菌临床分离株及其邻近革兰氏阳性正常菌群的抗生素耐药模式，并评估抗生素使用的作用。
这是一项在 6 个月研究期间就诊于选定皮肤科门诊的痤疮患者的横断面研究。从炎症性病变中获得的拭子进行需氧和厌氧培养。鉴定分离株并筛选抗生素敏感性。此外，所有患者均被要求填写一份问卷，其中包括有关抗生素治疗史的问题。
在纳入本研究的 115 名参与者中，有 100 名患者的病变中分离出痤疮丙酸杆菌。73%的分离株对红霉素耐药，59%对克林霉素耐药，37%对多西环素耐药，36%对四环素耐药，31%对甲氧苄啶/磺胺甲恶唑耐药，15%对左氧氟沙星耐药，3%对米诺环素耐药。大多数情况下，从同一患者中分离出的痤疮丙酸杆菌、金黄色葡萄球菌（金黄色葡萄球菌）和表皮葡萄球菌（表皮葡萄球菌）均存在类似的耐药模式，表现出多药耐药（MDR）。在以前因痤疮管理而接受抗生素治疗的患者中，观察到对可变抗生素的耐药性更高。
本研究的结果表明，痤疮丙酸杆菌对抗生素的耐药性分布情况以及抗生素的使用对抗生素耐药性的发展的影响。本研究中测试的皮肤细菌之间存在相似的耐药模式，突出了皮肤共生菌（包括金黄色葡萄球菌和表皮葡萄球菌）之间耐药基因的转移，从而促进了其在社区中的传播。
