Nucleic Acid Detection And Precision Use Of Drug For Resistant Acne

Background: Acne is one of the most common skin diseases in the world.Global statistics on the incidence of acne shows that acne is the eighth most common disease among all kinds of diseases,affecting nearly one sixth of the global population,mainly among teenagers.Domestic statistical studies have also been carried out,in the10-22 age range of the population,the prevalence rate is between 36%and 55%.Propionibacterium acnes,which causes facial acne disease,shows significant resistance.Currently,there is a lack of rapid detection methods for resistant acne in clinical practice,which limits the selection of antibiotics.Arms-q PCR is an accurate detection method based on genetic testing to quickly determine the typing of Bacillus acne,through which sample genes can be accurately detected.Objective: To determine the drug resistance ratio of different antibiotics in acne patients in this area,and to provide basis for clinical selection of antibiotics.At the same time,a rapid and accurate detection method was established to guide the medication to avoid the influence of acne resistance on the follow-up treatment of patients.Methods: This study relied on ARMS technology to construct a new detection method to guide clinical drug use.In order to avoid the disadvantage that traditional ARMS technology method and probe method could not distinguish neighboring bases,the method adopted in this study creatively used annexation bases to solve this problem.Arms-q PCR detects propionibacterium acnes by designed primers and probes,and determines whether the sample is propionibacterium acnes and whether the genotype of the strain is drug resistant according to the Ct difference measured in the experiment.After the method was successfully constructed,encapsulation and clinical verification were carried out to determine whether the ARMs-QPCR detection method has a significant effect on the therapeutic effect of precision medication.Results :(1)the genotypes of propionibacterium acnes were determined by Ct values of different primers.1.When Ct(erm X-16S)≤6.10,erm X gene was carried,and vice versa;2.When Ct(58T-58A)≤ 10.5and Ct(59G-59A)> 9.5 and Ct(58G-58A)> 8.0,does not carry 2058 or2059 mutation;3.When Ct(58T-58A)≤ 10.5,A2058 T mutation was carried;if Ct(59G-59A)≤ 6.50,A2059 G mutation was also carried;4.Without A2058 T mutation,when Ct(59G-59A)≤ 9.5,A2059 G mutation was carried;if Ct(58G-58A)≤ 5.00,A2058 G mutation was also carried;5.When both A2058 T and A2059 G mutations are not included,only A2058 G mutations are included when Ct(58G-58A)≤ 8.00.(2)The experimental results showed that the drug resistance of acne in this region to antibiotics was 50.9% of erythromycin,49.1% of clarithromycin,50.9% of azithromycin,57.3% of clindamycin and 1% of doxycycline.No drug resistance of minocycline was found.Conclusions :(1)a drug-resistant acne detection kit based on ARMS-q PCR was successfully developed.(2)In Changsha area,erythromycin,clarithromycin,azithromycin and clindamycin were all resistant,while doxycycline and minocycline were hardly resistant.(3)The clinical success of ARMS-q PCR test guiding drug use has been verified.