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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front. Med.    2016, Vol. 10 Issue (4) : 517-521     DOI: 10.1007/s11684-016-0480-9
RESEARCH ARTICLE |
Antimicrobial activity of topical agents against Propionibacterium acnes: an in vitro study of clinical isolates from a hospital in Shanghai, China
Ying Ma1,Nanxue Zhang1,Shi Wu2,Haihui Huang2,Yanpei Cao3()
1. Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China
2. Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China
3. Nursing Department, Huashan Hospital, Fudan University, Shanghai 200040, China
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Abstract  

This study aimed to compare the antimicrobial activities of topical agents against Propionibacterium acnes isolated from patients admitted to a hospital in Shanghai, China. The minimal inhibitory concentrations of the cultured P. acnes were determined in accordance with the Clinical and Laboratory Standards Institute. Susceptibilities to clindamycin and erythromycin were compared in terms of gender, age, disease duration, previous treatment, and disease severity. A total of 69 P. acnes strains were isolated from 98 patients (70.41%). The susceptibility to triple antibiotic ointment (neomycin/bacitracin/polymyxin B) and bacitracin was 100%. The susceptibility to fusidic acid was 92.7%. The resistance rates to neomycin sulfate, erythromycin, and clindamycin were 11.7%, 49.3%, and 33.4%, respectively. The high resistance rate to clindamycin and erythromycin was significantly affected by gender, previous treatment, and disease severity rather than by age and disease duration. Topical antibiotics should not be used separately for long-term therapy to avoid multiresistance. The use of topical antibiotics should be determined by clinicians on the basis of clinical conditions.

Keywords antimicrobial susceptibility/resistance      Propionibacterium acnes      topical antibiotics      in vitro study     
Corresponding Authors: Yanpei Cao   
Just Accepted Date: 04 November 2016   Online First Date: 25 November 2016    Issue Date: 01 December 2016
URL:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-016-0480-9     OR     http://academic.hep.com.cn/fmd/EN/Y2016/V10/I4/517
Antibiotic name Breakpoints Number % R % I % S MIC50 MIC90 MIC Range
S R
Neomycin sulfate ≤10 69 11.7 0 88.3 8 16 1–16
Bacitracin ≤2 69 0 0 100 0.5 1 ≤0.25–2
Polymyxin B ≤2 69 100 0 0 128 >128 32 to>128
TAO ≤10 69 0 0 100 2 2 ≤0.25–8
Mupirocin ≤8 >256 69 100 0 0 >12 >512 >512
FA ≤1 ≥4 69 0 7.3 92.7 1 1 0.25–2
Clindamycin ≤2 ≥8 69 33.4 11.6 55 0.5 >128 ≤0.06 to>128
Erythromycin ≤5 ≥8 69 49.3 0 50.7 64 >128 ≤0.06 to>128
Tab.1  Susceptibility and resistance rates (%) of topical antibiotics against P. acnes
Clindamycin (%) Erythromycin (%)
Gender Male (n = 41) 58.95±0.87 57.53±8.36
Female (n = 28) 35.99±7.02 23.49±8.25
P value <0.05* <0.05*
Age <25 years (n = 49) 55.27±7.77 47.18±10.76
≥25 years (n = 20) 60.32±5.50 54.76±14.87
P value 0.862 0.781
Disease duration <2 years (n = 55) 56.53±13.65 51.07±13.56
≥2 years (n = 14) 50.00±10.00 50.00±10.00
P value 0.816 0.968
Previous treatment Oral antibiotics (n = 33) 41.82±6.29 39.09±5.53
Topical antibiotics (n = 30) 53.33±5.77 40.00±10.00
Oral isotretinoin (n = 16) 50.00±10.00 56.67±5.77*3,4
Topical retinoids (n = 31) 61.52±7.84*1 65.15±5.01*1,2
Disease severity I (n = 5) 66.67±28.87 66.67±28.87
II (n = 17) 70.00±12.02 64.45±3.85
III (n = 26) 53.71±3.21 42.13±4.01
IV (n = 21) 31.19±2.30*1,2 36.19±7.19*1
Tab.2  Susceptibility rates for clindamycin and erythromycin as a function of gender, age, disease duration, previous treatment, and disease severity (%)
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