An increased incidence of Propionibacterium acnes biofilms in acne vulgaris: a case-control study

Jahns, Anika C.; Lundskog, Bertil; Gancevičienė, Rūta; Palmer, Ruth; Golovleva, Irina; Zouboulis, Christos C.; McDowell, Andrew; Patrick, Sheila; Alexeyev, Oleg A.

doi:10.1111/j.1365-2133.2012.10897.x

Cited by 204 publications

(193 citation statements)

References 43 publications

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“…In addition, MICs for the tea tree oil components terpinen-4-ol and ␣-terpineol were 0.16-0.31% and 0.08-0.16%, respectively, against one P. acnes strain [33]. These studies were performed with bacterial cells in a free-living or planktonic state, whereas recent evidence suggests that P. acnes exists within macrocolonies or a biofilm within skin follicles [35]. In general, bacteria growing within biofilms are more difficult to eradicate than their planktonic counterparts and this may be one of the factors contributing to the relatively long time that it can take to improve acne after commencement of treatment [36].…”

Section: Properties Of Tea Tree Oil Contributing To Clinical Efficacymentioning

confidence: 95%

Treatment of acne with tea tree oil (melaleuca) products: A review of efficacy, tolerability and potential modes of action

Hammer

2015

International Journal of Antimicrobial Agents

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Section: Properties Of Tea Tree Oil Contributing To Clinical Efficacymentioning

confidence: 95%

Treatment of acne with tea tree oil (melaleuca) products: A review of efficacy, tolerability and potential modes of action

Hammer

2015

International Journal of Antimicrobial Agents

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“…acne vulgaris reveal P. acnes on skin biopsy compared with 21% of control individuals [14]. Affected individuals also demonstrate P. acnes biofilms within the follicle in 37% of patients compared with only 13% of controls.…”

Section: Journal Of Clinical and Experimental Dermatology Researchmentioning

confidence: 89%

The Role of Propionibacterium acnes Biofilm in Acne Vulgaris

Linfante¹,

Allawh²,

Allen³

2017

J Clin Exp Dermatol Res

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Acne vulgaris is traditionally known as the result of excess sebum production, follicular hyper keratinization, infection with Propionibacterium acnes, and follicular inflammation. However, the role of P. acnes is gaining momentum as the primary impetus in the pathogenesis of acne vulgaris. The biofilm-forming ability of P. acnes in vitro and on indwelling medical appliances and catheters has been known for quite some time, but only in the last decade has the presence of P. acnes biofilm been observed within the pilosebaceous unit. Since that time, the genome of the microbe has been sequenced, and genes responsible for quorum sensing and biofilm formation have been confirmed. As a result of biofilm formation, the virulence of P. acnes is amplified. Biofilm-encapsulated P. acnes upregulates the production of lipases, resulting in the production of free fatty acids. Free fatty acids as well as the biofilm itself bind the Toll-like receptors TLR2 and TLR4, activating the innate immune system, culminating in a robust inflammatory response. Biofilms also appear to significantly contribute to antibiotic resistance. Acting as a physical barrier for antibiotics as well as a commune for bacteria to exchange antibiotic resistance genes, the biofilm plays an integral role as the major hurdle to treating acne vulgaris. Traditional antimicrobials have not shown much promise in disruption of the biofilm. Other approaches have been investigated utilizing a variety of novel topical compounds that act to prevent or disrupt the biofilm as a therapeutic modality. The role of biofilm in the pathogenesis of acne vulgaris has remained underappreciated, but with global antimicrobial resistance looming, further attention may be warranted.

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“…Propionibacteria are facultative, anaerobic, Gram-positive bacilli that form part of the normal bacterial flora of the skin, sebaceous glands and hair follicles [1][2][3]. Propionibacterium acnes is thought to play a key role in the pathogenesis of common acne, and recent evidence suggests that this might involve bacterial biofilm formation [1,4,5].…”

Section: Introductionmentioning

confidence: 99%

“…Propionibacterium acnes is thought to play a key role in the pathogenesis of common acne, and recent evidence suggests that this might involve bacterial biofilm formation [1,4,5].…”

Section: Introductionmentioning

confidence: 99%

Invasive Propionibacterium acnes infections in a non-selective patient cohort: clinical manifestations, management and outcome

Tebruegge

Jones

Sukhtankar

et al. 2014

Eur J Clin Microbiol Infect Dis

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An increasing number of reports suggest that Propionibacterium acnes can cause serious invasive infections. Currently, only limited data exist regarding the spectrum of invasive P. acnes infections. We conducted a non-selective cohort study at a tertiary hospital in the UK over a 9-year-period (2003-2012) investigating clinical manifestations, risk factors, management, and outcome of invasive P. acnes infections. Forty-nine cases were identified; the majority were neurosurgical infections and orthopaedic infections (n = 28 and n = 15 respectively). Only 2 cases had no predisposing factors; all neurosurgical and 93.3 % of orthopaedic cases had a history of previous surgery and/or trauma. Foreign material was in situ at the infection site in 59.3 % and 80.0 % of neurosurgical and orthopaedic cases respectively. All neurosurgical and orthopaedic cases required one or more surgical interventions to treat P. acnes infection, with or without concomitant antibiotic therapy; the duration of antibiotic therapy was significantly longer in the group of orthopaedic cases (median 53 vs 19 days; p = 0.0025). All tested P. acnes isolates were susceptible to penicillin, ampicillin and chloramphenicol; only 1 was clindamycin-resistant. Neurosurgical and orthopaedic infections account for the majority of invasive P. acnes infections. Most cases have predisposing factors, including previous surgery and/or trauma; spontaneous infections are rare. Foreign material is commonly present at the site of infection, indicating that the pathogenesis of invasive P. acnes infections likely involves biofilm formation. Since invasive P. acnes infections are associated with considerable morbidity, further studies are needed to establish effective prevention and optimal treatment strategies.

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An increased incidence of Propionibacterium acnes biofilms in acne vulgaris: a case-control study

Cited by 204 publications

References 43 publications

Treatment of acne with tea tree oil (melaleuca) products: A review of efficacy, tolerability and potential modes of action

Treatment of acne with tea tree oil (melaleuca) products: A review of efficacy, tolerability and potential modes of action

The Role of Propionibacterium acnes Biofilm in Acne Vulgaris

Invasive Propionibacterium acnes infections in a non-selective patient cohort: clinical manifestations, management and outcome

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