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Propionibacterium acnes resistance: a worldwide problem.

E A Eady1, M Gloor, J J Leyden

  • 1University of Leeds, Leeds, UK.

Dermatology (Basel, Switzerland)
|February 5, 2003
PubMed
Summary

Antibiotic resistance in Propionibacterium acnes has emerged, particularly with erythromycin and tetracyclines, following widespread topical and systemic use. New resistance mechanisms may also be developing, necessitating reduced antibiotic use in acne treatment.

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Area of Science:

  • Dermatology
  • Microbiology
  • Molecular Biology

Background:

  • Antibiotic therapy targeting Propionibacterium acnes has been a primary acne treatment for over 40 years.
  • Widespread use of systemic tetracyclines and erythromycin initially showed minimal impact on P. acnes sensitivity.
  • Clinically significant changes in P. acnes antibiotic sensitivity emerged in the early 1980s.

Purpose of the Study:

  • To investigate the evolution of antibiotic resistance in Propionibacterium acnes.
  • To identify the genetic basis and geographical spread of P. acnes antibiotic resistance.
  • To highlight the need for revised antibiotic stewardship in acne management.

Main Methods:

  • Monitoring P. acnes antibiotic sensitivity through clinical surveys.
  • Identifying mutations in ribosomal RNA genes (23S and 16S) associated with resistance.
  • Analyzing resistance patterns across different geographical regions (UK, USA, Europe, Japan, Australia).

Main Results:

  • The late 1980s saw increased prevalence of high-level erythromycin resistance and elevated tetracycline resistance in P. acnes strains.
  • Mutations in 23S and 16S ribosomal RNA genes were identified as a key mechanism of resistance.
  • Unidentified resistance mechanisms were also observed in some P. acnes strains.

Conclusions:

  • The emergence and spread of antibiotic resistance in P. acnes pose a significant challenge to acne therapy.
  • Identified mutations in ribosomal RNA genes explain a substantial portion of resistance.
  • The presence of unknown resistance mechanisms underscores the need for novel therapeutic strategies and judicious antibiotic use.

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