Antibiotic susceptibility of Propionibacterium acnes isolated from patients with acne in a public hospital in Southwest China: prospective cross-sectional study
Antibiotic susceptibility of Propionibacterium acnes isolated from patients with acne in a public hospital in Southwest China: prospective cross-sectional study
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中国西南地区某公立医院痤疮患者分离的痤疮丙酸杆菌的抗生素敏感性：前瞻性横断面研究
DOI：
10.1136/bmjopen-2018-022938
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发表时间：
2019-06-01
期刊：
影响因子：
2.9
通讯作者：
Sun, Dongjie
中科院分区：
文献类型：
--
作者：
Zhu, Tingting;Zhu, Wenyi;Sun, Dongjie
目的痤疮丙酸杆菌（Propionibacterium acnes，P. acnes）的耐药性已成为全球性的问题。只有一项相关的中国研究可用。本研究的目的是评估从中国西南部痤疮患者中获得的痤疮丙酸杆菌的抗生素敏感性。设计这是一项前瞻性横断面研究。从375名患者的面部痤疮病变中获得皮肤样本。将样品在厌氧培养基中培养以鉴定痤疮丙酸杆菌的存在。使用Epsilometer试验对分离的痤疮丙酸杆菌进行四环素、强力霉素、克林霉素、红霉素、阿奇霉素和克拉霉素的敏感性试验。结果从227例患者中分离出痤疮丙酸杆菌，224株（98.7%）对强力霉素敏感，220株（96.9%）对四环素敏感，101株（44.5%）对克林霉素敏感，102株（44.93%）对克拉霉素敏感。痤疮丙酸杆菌对红霉素敏感96例（42.3%），其次为阿奇霉素94例（41.4%）。与未接受抗生素治疗的患者相比，接受抗生素（局部和口服）治疗的受试者具有更高的耐药性痤疮丙酸杆菌频率以及更高的抗生素最低抑制浓度。结论痤疮丙酸杆菌对多西环素和四环素类抗生素高度敏感。痤疮丙酸杆菌对红霉素、阿奇霉素、克拉霉素、克林霉素等大环内酯类-林可酰胺类-链阳性菌素类抗生素耐药率较高。在中国和其他地方，痤疮治疗中抗生素的不合理使用可能是一个问题。这些结果表明，皮肤科医生应该更谨慎地处方抗生素痤疮。
Objective Antibiotics have been routinely used for several decades against Propionibacterium acnes (P. acnes), but antibiotic resistance of P. acnes is becoming a global problem. Only one related Chinese study is available. The aim of this study was to assess the antibiotic susceptibility of P. acnes obtained from patients with acne in Southwest China. Design This was a prospective cross-sectional study. Cutaneous samples were obtained from acne lesions on the face of 375 patients. Samples were cultured in anaerobic medium to identify the presence of P. acnes. Susceptibility tests of isolated P. acnes were performed for tetracycline, doxycycline, clindamycin, erythromycin, azithromycin and clarithromycin using the Epsilometer test. Results P. acnes was isolated from 227 patients; 224 isolates (98.7%) were susceptible to doxycycline and 220 (96.9%) were susceptible to tetracycline, followed by clindamycin and clarithromycin in 101 (44.5%) and 102 (44.93%) isolates, respectively. Susceptibility of P. acnes was detected for erythromycin in 96 (42.3%) patients, followed by azithromycin in 94 (41.4%). Subjects who received antibiotics (topical and oral) had higher frequencies of antibiotic-resistant P. acnes as well as increased antibiotic minimum inhibitory concentrations compared with patients without antibiotic treatment. Conclusions P. acnes was highly sensitive to cyclines (doxycycline and tetracycline). P. acnes showed higher resistance rates to macrolides–lincosamides–streptogramins antibiotics (such as erythromycin, azithromycin, clarithromycin and clindamycin). The irrational use of antibiotics for acne treatment is probably a problem in China and elsewhere. These results suggest that dermatologists should be more prudent in prescribing antibiotics for acne.