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Title: Propionibacteria Resistant To Antibiotics Hamper Acne Treatment

URL: http://www.blackwell-synergy.com/servlet/useragent?func=synergy&
&synergyAction=showAbstract&doi=10.1046/j.1365-2133.2002.04690.x

British Journal of Dermatology 2002;146(5):840-848. "Prevalence of antibiotic-resistant propionibacteria on the skin of acne patients: 10-year surveillance data and snapshot distribution study"
05/21/2002 11:31:10 AM
By David Loshak

Resistant propionibacteria, widely distributed on acne-prone skin and in the nares, may be difficult to eradicate using existing treatments, say specialists in Leeds, England. Although cutaneous propionibacteria were implicated in acne pathogenesis, the exact role in causing inflammation was unclear. Also, there were few formal data on prevalence and distribution. Antibiotics and other agents which reduced the numbers of propionibacteria on skin were therapeutic but resistance in the target organism often developed. The specialists monitored the prevalence of skin colonisation by antibiotic-resistant propionibacteria in 4,274 acne patients at a dermatology out-patient clinic over 10 years from 1991. They also examined the distribution of resistant strains on acne-prone skin and in the nares. The specialists obtained propionibacterial samples from the skin surface of the worst affected site, usually the face, with a moistened swab. The swab was used to inoculate agar plates with and without selective antibiotics. After anaerobic incubation at 37°C for seven days, the amount of growth in the presence of each antibiotic was scored. The proportion of patients carrying strains resistant to one or more commonly used anti-acne antibiotics rose steadily from 34.5 percent in 1991 to 64 percent in 1997. The prevalence dropped to 50.5 percent during 1999, but rose to 55.5 percent in 2000. Resistance to erythromycin was the most common. Most erythromycin-resistant strains were cross-resistant to clindamycin. Resistance to tetracyclines was less common in all years and with little increase over time. More detailed quantitative sampling at six different sites on 72 patients, which examined the distribution of resistant propionibacteria on acne-prone skin and in the anterior nares, showed that population densities of resistant propionibacteria varied greatly between sites and between individuals. Almost always, patients were colonised with resistant strains at multiple sites, including the nares.

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