Antibacterial Susceptibility Testing of Cutibacterium acnes in Acne Vulgaris Patients

Abstract

Ievads: Kombinētā terapija tiek plaši izmantota acne vulgaris (AV) ārstēšanai, ieskaitot vietējos pretiekaisuma medikamentus, kas satur pretmikrobu līdzekļus, piemēram, klindamicīnu vai eritromicīnu, lai kavētu Cutibacterium acnes (C. acnes) augšanu un vienlaikus samazinātu iekaisuma mediatoru ražošanu. Pētījuma mērķis ir salīdzināt C. acnes antibakteriālo jutību pret klindamicīnu un eritromicīnu AV pacientiem, salīdzinot ar veseliem pacientiem kontroles grupā (CG). Metodes: prospektīvajā pētījumā tika iekļauti 56 pacienti ar klīniski diagnosticētiem AV simptomiem un 12 pacienti tika iekļauti CG, kuriem nebija AV. AV grupā no pacienta paņemtais paraugs bija pustulu saturs, kas iegūts, izspiežot pustulas, bet CG, paraugā bija tauku dziedzeru saturs. Visi paraugi tika kultivēti kombinētajā Muellera-Hintona cietajā vidē. Identifikācija tika veikta ar VITEK2, kam sekoja izolēto C. acnes celmu antibakteriālās jutības noteikšana ar E-testu. Rezultāti: C. acnes tika izolētas no 28 (50%) paraugiem AV grupā, savukārt CG, C. acnes tika izolētas no 10 paraugiem (80%). Abās grupās rezistence pret klindamicīnu bija līdzīga, 6 (21,4%) paraugos no AV grupas pacientiem un 2 (20,0%) paraugos CG, bet rezistence pret eritromicīnu AV pacientiem bija augstāka, salīdzinot ar CG, attiecīgi 8 (28,6%) un 1 (10%). Secinājumi: pacientiem ar AV ir augstāks rezistences līmenis pret eritromicīnu nekā CG, savukārt rezistence pret klindamicīnu ir līdzīga. Rezistences dati statistiski neuzrādīja nozīmīgu saikni starp eritromicīna un klindamicīna lietošanu un rezistences attīstību. CG tika konstatēts vairāk C. acnes nekā AV grupā.

Introduction: Combination therapy is widely used for the treatment of acne vulgaris (AV), including local anti-inflammatory drugs containing antimicrobials, such as clindamycin or erythromycin, to inhibit Cutibacterium acnes (C. acnes) growth and at the same time reduce the production of inflammatory mediators. The aim of the study is to compare the antibacterial susceptibility of C. acnes to clindamycin and erythromycin in AV patients compared with healthy patients in the control group (CG). Methods: The prospective study included 56 patients with clinically diagnosed AV symptoms and 12 patients were included in the CG who did not have AV. In the AV group, patient specimen was contents of pustules obtained by squeezing pustules, but in the CG, the specimen was content of sebaceous glands. All specimens were cultivated on a combined Mueller–Hinton solid medium. Identification was done by VITEK2 and followed by determination of antibacterial susceptibility of the isolated C. acnes strains by E-test. Results: C. acnes was isolated from samples of 28 (50%) in the AV group, whereas in the CG, C. acnes was isolated from 10 samples (80%). Resistance to clindamycin in both groups was similar, in 6 (21.4%) samples from patients in the AV group and in 2 (20.0%) samples in the CG, but resistance to erythromycin in the AV patients was higher compared to the CG, in 8 (28.6%) and 1 (10%) accordingly. Conclusion: Patients with AV have higher rates of resistance to erythromycin than the CG, while resistance to clindamycin is comparable. Resistance data showed no statistically significant association between use of erythromycin and clindamycin and the development of resistance. More C. acnes were identified in the CG than in the AV group.