Clonality and Anatomic Distribution on the Skin of Antibiotic Resistant and Sensitive Propionibacterium acnes

Abstract

Increasing antibiotic resistance in the population of Propionibacterium acnes is a major concern. Our aims were to examine the clonal relationships and anatomical distribution of resistant and sensitive P. acnes. A collection of 350 P. acnes isolates was therefore used to determine the minimum inhibitory concentration of tetracycline, erythro-mycin and clindamycin, multilocus sequence type, and the identity of genetic resistance markers. Two hitherto unknown resistance mutations were detected. Resistant P. acnes mainly belonged to clonal clusters in division I-1a frequently isolated from skin and associated with moderate to severe acne. All high-level tetracycline resistant strains were members of a single clone. Multiple isolates from distinct anatomic areas of surface skin and follicles of 2 acne patients revealed substantial clonal diversity between areas and co-existence of resistant and sensitive clones. Fifty-two percent of Danish acne patients and 43% of controls carried at least one resistant P. acnes strain, resistance to clindamycin being most frequent followed by tetracycline and erythromycin. Resistance to tetracycline was detected exclusively among isolates from acne patients. In conclusion, antibiotic resistance is associated with particular evolutionary clades of P. acnes and a substantial part is due to a single geographically widespread clone (ST3). Individuals carry a strikingly complex population of P. acnes with distinct virulence potential and antibiotic resistance.

Different Propionibacterium acnes Phylotypes Induce Distinct Immune Responses and Express Unique Surface and Secreted Proteomes

“…The potential for linking the proteome with specific immune responses may allow for the identification of protein vaccines candidates, a form of treatment which may be promising for acne (Kim, 2008;Simonart, 2013) and avoids antibiotic resistance (Lomholt and Kilian, 2014).…”

Characterisation of Cutibacterium acnes phylotypes in acne and in vivo exploratory evaluation of Myrtacine®

“…The literature reports various levels of resistance among C. acnes strains: from 6.1% to 7.6% of EryR strains 31 to 98% of EryR strains, 32 with various intermediate levels. [33][34][35][36][37][38] Nevertheless, it is worth mentioning that in most of these studies, (i) sampling was performed on the skin (with swabs) and did not always take into account the pilosebaceous gland containing C. acnes; and (ii) one Cutibacterium isolate (the main) per patient was isolated by culture on nonselective agar (without antibiotics), then its sensibility to antibiotics was analysed. By contrast, in our study, Cutibacterium from superficial pilosebaceous follicles were directly grown on selective agar.…”

Analysis of the surface, secreted, and intracellular proteome of Propionibacterium acnes

“…It is also a significant organism in infections of the prostate [3], prosthetic joints [4], other surgical implants [5], spinal discs [6], and ophthalmic infections [7]. Unfortunately, the bacteria in many cases are resistant to antibiotic therapy [8, 9], and other treatments often have low patient compliance [10]. Thus, the need exists for novel approaches to develop treatments that are more effective against P. acnes and have fewer side effects.…”