Please wait a minute...
Shopping Cart Email List Chinese
Advanced Search Fig/Tab
Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Featured Articles  |  Most Downloaded  |  Most Reading
Online Submission Subscribe to Our RSS Content Feed
Front. Med.    2016, Vol. 10 Issue (4) : 517-521    https://doi.org/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
 Download: PDF(103 KB)   HTML
 Export: BibTeX | EndNote | Reference Manager | ProCite | RefWorks
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 Author(s): Yanpei Cao   
Just Accepted Date: 04 November 2016   Online First Date: 25 November 2016    Issue Date: 01 December 2016
 Cite this article:   
Ying Ma,Nanxue Zhang,Shi Wu, et al. Antimicrobial activity of topical agents against Propionibacterium acnes: an in vitro study of clinical isolates from a hospital in Shanghai, China[J]. Front. Med., 2016, 10(4): 517-521.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-016-0480-9
https://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 (%)
15 Tanghetti E. The impact and importance of resistance. Cutis 2007; 80(1 Suppl): 5–9
pmid: 17824580
16 Yun HJ, Lee SW, Yoon GM, Kim SY, Choi S, Lee YS, Choi EC, Kim S. Prevalence and mechanisms of low- and high-level mupirocin resistance in staphylococci isolated from a Korean hospital. J Antimicrob Chemother 2003; 51(3): 619–623
https://doi.org/10.1093/jac/dkg140 pmid: 12615863
1 Beylot C, Auffret N, Poli F, Claudel JP, Leccia MT, Del Giudice P, Dreno B. Propionibacterium acnes: an update on its role in the pathogenesis of acne. J Eur Acad Dermatol Venereol 2014; 28(3): 271–278
https://doi.org/10.1111/jdv.12224 pmid: 23905540
17 Bonamonte D, Belloni Fortina A, Neri L, Patrizi A. Fusidic acid in skin infections and infected atopic eczema. G Ital Dermatol Venereol 2014; 149(4): 453–459
pmid: 25068235
18 Williamson DA, Monecke S, Heffernan H, Ritchie SR, Roberts SA, Upton A, Thomas MG, Fraser JD. High usage of topical fusidic acid and rapid clonal expansion of fusidic acid-resistant Staphylococcus aureus: a cautionary tale. Clin Infect Dis 2014; 59(10): 1451–1454
https://doi.org/10.1093/cid/ciu658 pmid: 25139961
2 Haider A, Shaw JC. Treatment of acne vulgaris. JAMA 2004; 292(6): 726–735
https://doi.org/10.1001/jama.292.6.726 pmid: 15304471
3 Ross JI, Snelling AM, Carnegie E, Coates P, Cunliffe WJ, Bettoli V, Tosti G, Katsambas A, Galvan Peréz Del Pulgar JI, Rollman O, Török L, Eady EA, Cove JH. Antibiotic-resistant acne: lessons from Europe. Br J Dermatol 2003; 148(3): 467–478
https://doi.org/10.1046/j.1365-2133.2003.05067.x pmid: 12653738
4 Gollnick H, Cunliffe W, Berson D, Dreno B, Finlay A, Leyden JJ, Shalita AR, Thiboutot D; Global Alliance to Improve Outcomes in Acne. Management of acne: a report from a Global Alliance to Improve Outcomes in Acne. J Am Acad Dermatol 2003; 49(1 Suppl): S1–S37 PMID:12833004
https://doi.org/10.1067/mjd.2003.618
5 Bonomo RA, Van Zile PS, Li Q, Shermock KM, McCormick WG, Kohut B. Topical triple-antibiotic ointment as a novel therapeutic choice in wound management and infection prevention: a practical perspective. Expert Rev Anti Infect Ther 2007; 5(5): 773–782
https://doi.org/10.1586/14787210.5.5.773 pmid: 17914912
6 Cesur S. Topical antibiotics and clinical use. Mikrobiyol Bul 2002; 36(3-4): 353–361
pmid: 12838671
7 Khorvash F, Abdi F, Kashani H H, Fatemi Naeini F, Khorvash F. Efficacy of mupirocin and rifampin used with standard treatment in the management of acne vulgaris. Iran J Pharm Res 2013; 12(1): 223–227 PMID:24250593
8 Ramli R, Malik AS, Hani AF, Jamil A. Acne analysis, grading and computational assessment methods: an overview. Skin Res Technol 2012; 18(1): 1–14
https://doi.org/10.1111/j.1600-0846.2011.00542.x pmid: 21605170
9 Dreno B, Gollnick HP, Kang S, Thiboutot D, Bettoli V, Torres V, Leyden J. Understanding innate immunity and inflammation in acne: implications for management. J Eur Acad Dermatol Venereol 2015; 29 (Suppl 4): 3–11
10 Rathi SK. Acne vulgaris treatment: the current scenario. Indian J Dermatol 2011; 56(1): 7–13
https://doi.org/10.4103/0019-5154.77543 pmid: 21572783
11 Del Rosso JQ, Kim GK. Topical antibiotics: therapeutic value or ecologic mischief? Dermatol Ther (Heidelb) 2009; 22(5): 398–406
https://doi.org/10.1111/j.1529-8019.2009.01256.x pmid: 19845717
12 Tan HH. Antibacterial therapy for acne: a guide to selection and use of systemic agents. Am J Clin Dermatol 2003; 4(5): 307–314
https://doi.org/10.2165/00128071-200304050-00002 pmid: 12688836
13 Aubin GG, Portillo ME, Trampuz A, Corvec S. Propionibacterium acnes, an emerging pathogen: from acne to implant-infections, from phylotype to resistance. Med Mal Infect 2014; 44(6): 241–250
https://doi.org/10.1016/j.medmal.2014.02.004 pmid: 24656842
14 Del Rosso J. Emerging topical antimicrobial options for mild-to-moderate acne: a review of the clinical evidence. J Drugs Dermatol 2008; 7(2 Suppl): s2–s7
pmid: 18404864
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed