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Correlation between Antimicrobial Resistant Propionibacterium acnes and Severity of Acne Vulgaris: Findings from a
Maria Mayfinna Gozali1, Yuli Kurniawati1, Mutia Devi1
1From the Department of Dermatology and Venereology, Sriwijaya University, Palembang, Indonesia.
Abstract:
The study of antimicrobial-resistant Propionibacterium acnes was not conducted regularly, especially in Indonesia. Conversely, regular monitoring of antibiotic efficacy through in vitro testing to assess the evolution of current resistance patterns is obligated; thus, filling the gap caused by a lack of appropriate antibiotic surveillance is required. Analyse the correlation between resistance patterns of P. acnes to doxycycline, clindamycin, erythromycin and azithromycin with the severity of acne vulgaris. This is an analytic observational laboratory study with a cross-sectional design of mild to severe acne vulgaris (AV) patients. Specimens were obtained from comedones of 71 patients, which were cultured and identified using biochemical examination. Antimicrobial resistance (doxycycline, clindamycin, erythromycin and azithromycin) to P. acnes was tested by disc diffusion method. Among 71 samples collected, 40 (56.3%) P. acnes isolates were cultured and identified. The incidence of P. acnes resistance to more than one antimicrobial was 45%. Antimicrobial resistances were clindamycin 42.5%, erythromycin 40%, azithromycin 23.5% and doxycycline 12.5%, respectively. According to the contingency coefficient test, there was moderate correlation between the resistance pattern of P. acnes to clindamycin (r = 0.485, P = <0.001) and doxycycline (r = 0.433, P = 0.002) and AV severity. There was weak correlation between the resistance pattern of P. acnes to erythromycin (r = 0.333; P = 0.025) and azithromycin (r = 0.321; P = 0.032) and AV severity. In conclusion, there is a correlation between the pattern of P. acnes resistance to doxycycline, clindamycin, erythromycin, azithromycin and severity of AV.
Insights
Antimicrobial resistance in Propionibacterium acnes (P. acnes) is a growing concern for acne vulgaris. This study found correlations between P. acnes resistance to common antibiotics and acne severity.
Area of Science:
- Dermatology and Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Antimicrobial resistance in Propionibacterium acnes (P. acnes) is not regularly studied in Indonesia.
- Monitoring antibiotic efficacy and resistance patterns is crucial for effective acne vulgaris treatment.
- A lack of antibiotic surveillance necessitates research into P. acnes resistance.
Purpose of the Study:
- To analyze the correlation between P. acnes resistance patterns to doxycycline, clindamycin, erythromycin, and azithromycin and the severity of acne vulgaris.
- To address the gap in antibiotic surveillance for P. acnes in Indonesia.
- To provide data on antibiotic resistance relevant to acne vulgaris management.
Main Methods:
- Analytic observational laboratory study with a cross-sectional design.
- Involved 71 patients with mild to severe acne vulgaris.
- P. acnes isolates were cultured, identified biochemically, and tested for antimicrobial resistance using the disc diffusion method.
Main Results:
- 40 (56.3%) P. acnes isolates were successfully cultured.
- 45% of isolates showed resistance to more than one antimicrobial.
- Resistance rates: clindamycin (42.5%), erythromycin (40%), azithromycin (23.5%), and doxycycline (12.5%).
- Moderate correlation found between P. acnes resistance to clindamycin and doxycycline and acne severity (P < 0.001 and P = 0.002, respectively).
- Weak correlation found between resistance to erythromycin and azithromycin and acne severity (P = 0.025 and P = 0.032, respectively).
Conclusions:
- There is a significant correlation between P. acnes resistance patterns to doxycycline, clindamycin, erythromycin, and azithromycin and the severity of acne vulgaris.
- The findings highlight the importance of antibiotic surveillance for P. acnes.
- Understanding resistance patterns is essential for guiding appropriate acne treatment strategies.
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