| Objectives : 1.Clarify the drug resistance condition of Cutibacterium acnes(Cutibacterium acnes,C.acnes),Staphylococcus epidermidis(Staphylococcus epidermidis,S.epidermidis)and Staphylococcus aureus(Staphylococcus aureus,S.aureus)isolated from skin lesions of acne patients on the antibiotics commonly used in acne.2.Clarify the relationship between the antibiotic resistance of the above isolates and the severity of acne and previous acne treatments,especially the impact of physical therapy(red and blue light,chemical peeling,etc.)on drug resistance.3.Understand the detection of C.acnes,S.epidermidis and S.aureus in acne lesions and their relationship with patients’ gender,age,acne severity and previous acne treatment.Methods:From September 2022 to October 2022,149 patients with mild to severe acne vulgaris who were treated in the Department of Dermatology of our hospital were selected.After obtaining informed consent,the contents of facial acne lesions were collected from the patients.Cultivate,isolate,identify,and obtain C.acnes,S.epidermidis and S.aureus strains.Use the E-test method to evaluate the in vitro drug sensitivity of above bacteria against commonly used antibiotics for acne: tetracyclines(tetracycline,doxycycline,minocycline),macrolide-lincosamides(erythromycin,clindamycin),metronidazole and fusidic acid.The experimental data were statistically analyzed using IBM SPSS Statistics 25.0 software.Results:1.A total of 149 acne patients were included,the male to female ratio was1:2.47,and the overall average age was(23.56±5.07)years old.According to the Pillsbury classification method,13.4% were mild(grade I)and 36.9% were moderate(grade II),35.6% for moderate(grade III)and 14.1% for severe(grade IV).Acne treatment status of included patients within half a year: 11.4% without any treatment,49.0% with only medication,8.1% with only physical therapy,31.5% with combination of medication and physical therapy;among them,oral and(or)topical antibiotic therapy accounted for 56.4% of all drug therapy recipients.2.The detection rate of three isolates of acne skin lesions and its correlation with clinical features(1)139 strains of C.acnes(93.3%),143 strains of S.epidermidis(96%),and 7strains of S.aureus(4.7%)were cultured and identified from the skin lesions of 149 patients with acne.(2)Gender: there was no significant difference in the detection rates of C.acnes,S.epidermidis,and S.aureus between male and female patients(P>0.05);age: there was no significant difference in the detection rates of C.acnes,S.epidermidis and S.aureus between patients younger than 25 years old and those over 25 years old(P>0.05);severity of acne: there was no significant difference in the detection rates of C.acnes,S.epidermidis and S.aureus in patients with mild(grade I),moderate(grade II),moderate(grade III)and severe(grade IV)patients(P>0.05);previous acne treatment: there was no significant difference in the detection rates of C.acnes,S.epidermidis and S.aureus among patients who were not treated within half a year,those treated with antibiotics,and those treated with other treatments(no antibiotics)(P>0.05);there was no significant difference in the detection rates of C.acnes,S.epidermidis and S.aureus among patients who were not treated within half a year,those who received only physical therapy,and those who received other treatments(no physical therapy)(P>0.05).3.Drug susceptibility of the above three isolates to antibiotics commonly used in acne(1)C.acnes: 100% sensitive to tetracyclines(tetracycline,doxycycline and minocycline);100% resistant to metronidazole;42.4% resistant to erythromycin;39.6% resistant to clindamycin;the minimum inhibitory concentration(minimal inhibitory concentration,MIC)of fusidic acid fluctuated between ≤0.016～2ug/ml.(2)S.epidermidis: 100% sensitive to minocycline,only 9.8% resistant to tetracycline and doxycycline;100% resistant to metronidazole;80.4% resistant to erythromycin;49.7% resistant to clindamycin;the MIC of fusidic acid fluctuated between 0.25～64ug/ml.(3)S.aureus: 100% sensitive to doxycycline and minocycline,14.3% resistant to tetracycline;100% resistant to metronidazole;57.1% resistant to erythromycin;28.6%resistant to clindamycin;the MIC of fusidic acid fluctuated between0.094～>256ug/ml.4.Correlation of the antibiotic resistance rate of the above three isolates with the severity of acne and previous acne treatment(1)Correlation between the severity of acne and the drug resistance rate: C.acnes detected in patients with mild(grade I),moderate(grade II),moderate(grade III)and severe(grade IV)patients had no significant difference in the resistance rate of tetracycline antibiotics and macrolides and lincosamides(macrolides and lincosamides,ML)(P>0.05);there was no significant difference in the resistance rate of S.epidermidis to tetracycline antibiotics and ML(P>0.05);there was no significant difference in the resistance rate of S.aureus to tetracycline antibiotics and ML(P>0.05);C.acnes,S.epidermidis and S.aureus were completely resistant to metronidazole,and there was no difference among patients with different acne severity.(2)Correlation between previous antibiotic treatment and drug resistance rate:the resistance rate of C.acnes to ML detected in those who received oral macrolide antibiotics within half a year was significantly higher than that in those without antibiotics(P<0.05),the C.acnes detected in patients treated with tetracycline antibiotics were sensitive to tetracycline antibiotics;there was no significant difference in the resistance rate of S.epidermidis detected to tetracycline antibiotics and ML in patients receiving tetracycline antibiotics or ML treatment within half a year compared with those without antibiotic treatment(P>0.05);there was no significant difference in the resistance rate of S.aureus to ML between those who received ML treatment within half a year and those who received no antibiotic treatment(P>0.05),and none of the patients with S.aureus detected received tetracycline antibiotics within half a year.(3)Correlation between previous physical therapy and drug resistance rate: there was no significant difference in the resistance rate of C.acnes to tetracyclines and(or)ML detected in those who received only physical therapy within half a year,compared with those who were not treated and those who received other treatments(no physical therapy)(P>0.05);there was no significant difference in the resistance rate of S.epidermidis to tetracyclines and(or)ML detected in those who received only physical therapy within half a year,compared with those who were not treated and those who received other treatments(no physical therapy)(P>0.05);there was no significant difference in the resistance rate of S.aureus to tetracyclines and(or)ML in those who only received physical therapy within half a year,compared with those who were not treated and those who received other treatments(no physical therapy)(P>0.05).Conclusions:1.The bacteria isolated from the skin lesions of acne patients in a hospital in Yunnan were mainly S.epidermidis and C.acnes,and the detection rate of S.aureus was low;and the patient’s gender,age,acne severity,previous antibiotics and physical therapy It had no effect on the detection rate of the above three bacteria in acne lesions.2.The sensitivity of C.acnes,S.epidermidis and S.aureus to tetracycline antibiotics was much higher than that of ML,among them,the sensitivity to minocycline was the highest,and tetracyclines,especially minocycline,could be preferred in the treatment of acne.3.There was no significant correlation between the resistance rate of C.acnes,S.epidermidis and S.aureus to be resistant to antibiotics commonly used in clinical acne isolated from skin lesions of patients included in this study and the severity of acne.4.The drug resistance of C.acnes to ML might be closely related to the previous acceptance of macrolide antibiotics,and the daily use of systemic macrolide antibiotics in diseases including acne should be regulated;the impact of previous treatment with tetracycline antibiotics on drug resistance not big.5.In this study,common acne physical treatments such as red and blue light and chemical peeling did not induce C.acnes,S.epidermidis and S.aureus to be resistant to antibiotics commonly used in clinical acne,which could be one of the main options for acne treatment. |
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