Antibiotic resistance of microbial strains isolated from Korean acne patients

Abstract

Background: Over several decades, topical and systemic antibiotics have been the mainstay of treatment for mild to moderate acne vulgaris. The widespread and long-term use of both topical and oral antibiotics in the treatment of acne has resulted in the spread of resistant bacterial strains and treatment failure.Objective: The aim of this study was to examine the bacteriology of acne vulgaris and to evaluate its susceptibility to the antibiotics widely used for acne in Korea. Methods: I examined the species of bacteria aerobically and anaerobically isolated from 100 acne patients. The diameter of the zone of inhibition for tetracycline, doxycycline, minocycline, erythromycin, clindamycin, trimethoprim / sulfamethoxazole and levofloxacin were measured by the disk diffusion method.Results: Among the bacteria isolated, Staphylococcus epidermidis (S. epidermidis, 36 patients) was the most common, followed by Propionibacterium acnes (P. acnes, 30 patients). Eleven strains of P. acnes (36.7%) and twenty-five strains of S. epidermidis (69.4%) were resistant to one or other of the antibiotics tested. In antibiotic susceptibility tests a higher proportion of P. acnes isolates were resistant to clindamycin (30%) and erythromycin (26.7%), than to any other antibiotics tested (p=0.0003). Some S. epidermidis isolates were resistant to tetracycline and doxycycline in addition to clindamycin and erythromycin. On the other hand, there was a low frequency of resistance to minocycline. A history of precious antibiotic therapy was the only factor associated with antibiotic-resistance in P. acnes.Conclusions: The previous studies no strains were found to be resistant to any of the antibiotics, but this study shows that antibiotic-resistant P. acnes has emerged in Korea. The use of antibiotics influences the distribution of resistant bacterial isolates. It is important to choose antibiotics for acne treatment carefully, not only because antibiotic resistance can be a problem for general health, but also because resistance genes are transferable among bacteria, whether or not they belong to the same species. More studies are needed to develope additional screening tests for evaluating antibiotics for the treatment of acne vulgaris.