BACKGROUND: Cutaneous propionibacteria are implicated in acne pathogenesis, although their exact role in the genesis of inflammation is still poorly understood. Agents, including antibiotics, that reduce the numbers of propionibacteria on skin are therapeutic. Resistance in the target organism is a well-recognized consequence of antibiotic therapy for acne but formal prevalence and distribution data are lacking. OBJECTIVES: To monitor the prevalence of skin colonization by antibiotic-resistant propionibacteria in acne patients attending the dermatology out-patient clinic at Leeds General Infirmary over a 10-year period beginning in 1991, and to examine the distribution of resistant strains on acne-prone skin and in the nares. METHODS: Propionibacterial samples were obtained from the skin surface of the worst affected site (usually the face) of 4274 acne patients using a moistened swab. The swab was used to inoculate agar plates with and without selective antibiotics. After anaerobic incubation at 37 degrees C for 7 days, the amount of growth in the presence of each antibiotic was scored on a scale from 0 to 5+. A small number of patients (72) were selected for more detailed quantitative sampling at six different sites to examine the distribution of resistant propionibacteria on acne-prone skin and in the anterior nares. RESULTS: The proportion of patients carrying strains resistant to one or more commonly used antiacne antibiotics rose steadily from 34.5% in 1991 to a peak of 64% in 1997. The prevalence dropped to 50.5% during 1999 and then rose again to 55.5% in 2000. Resistance to erythromycin was the most common and the majority of erythromycin-resistant strains were cross-resistant to clindamycin. Resistance to tetracyclines was less common in all years and with little increase over time. The more detailed quantitative study in 72 patients showed that population densities of resistant propionibacteria varied considerably between sites and between individuals. Almost invariably, patients were colonized with resistant strains at multiple sites, including the nares. CONCLUSIONS: Skin colonization with antibiotic-resistant propionibacteria is much more common now than a decade ago. Resistant propionibacteria are widely distributed on acne-prone skin and in the nares. This suggests that they will be very difficult to eradicate using existing therapeutic regimens, especially from the nasal reservoir.
BACKGROUND: Cutaneous propionibacteria are implicated in acne pathogenesis, although their exact role in the genesis of inflammation is still poorly understood. Agents, including antibiotics, that reduce the numbers of propionibacteria on skin are therapeutic. Resistance in the target organism is a well-recognized consequence of antibiotic therapy for acne but formal prevalence and distribution data are lacking. OBJECTIVES: To monitor the prevalence of skin colonization by antibiotic-resistant propionibacteria in acne patients attending the dermatology out-patient clinic at Leeds General Infirmary over a 10-year period beginning in 1991, and to examine the distribution of resistant strains on acne-prone skin and in the nares. METHODS: Propionibacterial samples were obtained from the skin surface of the worst affected site (usually the face) of 4274 acne patients using a moistened swab. The swab was used to inoculate agar plates with and without selective antibiotics. After anaerobic incubation at 37 degrees C for 7 days, the amount of growth in the presence of each antibiotic was scored on a scale from 0 to 5+. A small number of patients (72) were selected for more detailed quantitative sampling at six different sites to examine the distribution of resistant propionibacteria on acne-prone skin and in the anterior nares. RESULTS: The proportion of patients carrying strains resistant to one or more commonly used antiacne antibiotics rose steadily from 34.5% in 1991 to a peak of 64% in 1997. The prevalence dropped to 50.5% during 1999 and then rose again to 55.5% in 2000. Resistance to erythromycin was the most common and the majority of erythromycin-resistant strains were cross-resistant to clindamycin. Resistance to tetracyclines was less common in all years and with little increase over time. The more detailed quantitative study in 72 patients showed that population densities of resistant propionibacteria varied considerably between sites and between individuals. Almost invariably, patients were colonized with resistant strains at multiple sites, including the nares. CONCLUSIONS: Skin colonization with antibiotic-resistant propionibacteria is much more common now than a decade ago. Resistant propionibacteria are widely distributed on acne-prone skin and in the nares. This suggests that they will be very difficult to eradicate using existing therapeutic regimens, especially from the nasal reservoir.
Authors: Andrew McDowell; Judit Hunyadkürti; Balázs Horváth; Andrea Vörös; Emma Barnard; Sheila Patrick; István Nagy Journal: J Bacteriol Date: 2012-06 Impact factor: 3.490
Authors: James Q Del Rosso; Guy F Webster; Ted Rosen; Diane Thiboutot; James J Leyden; Richard Gallo; Clay Walker; George Zhanel; Lawrence Eichenfield Journal: J Clin Aesthet Dermatol Date: 2016-04-01
Authors: Jamie E McInturff; Shyh-Jeun Wang; Thomas Machleidt; T Richard Lin; Ami Oren; Cheryl J Hertz; Stephan R Krutzik; Scott Hart; Karin Zeh; Daniel H Anderson; Richard L Gallo; Robert L Modlin; Jenny Kim Journal: J Invest Dermatol Date: 2005-08 Impact factor: 8.551
Authors: J Pannu; A McCarthy; A Martin; T Hamouda; S Ciotti; L Ma; J Sutcliffe; J R Baker Journal: Antimicrob Agents Chemother Date: 2011-07-11 Impact factor: 5.191
Authors: Jelena Barbaric; Rachel Abbott; Pawel Posadzki; Mate Car; Laura H Gunn; Alison M Layton; Azeem Majeed; Josip Car Journal: Cochrane Database Syst Rev Date: 2016-09-27
Authors: Laura J Marinelli; Sorel Fitz-Gibbon; Clarmyra Hayes; Charles Bowman; Megan Inkeles; Anya Loncaric; Daniel A Russell; Deborah Jacobs-Sera; Shawn Cokus; Matteo Pellegrini; Jenny Kim; Jeff F Miller; Graham F Hatfull; Robert L Modlin Journal: MBio Date: 2012-09-25 Impact factor: 7.867