Resistance status of antibiotics in Gram-positive bacteria isolated from acne lesions in İstanbul

Abstract

Background and Design: Acne vulgaris is a multifactorial disease in which Propionibacterium acnes is thought to play an important role in the pathogenesis of inflamed lesions. There is also significant in vitro evidence suggesting a possible pathogenetic role for Staphylococci in acne vulgaris and an in vitro study of patients who were undergoing evaluation for acne, showed that 53% of participants were colonised with Staphylococcus epidermidis. Materials and Methods: In this study, 29 P. acnes isolates and 61 coagulase-negative staphylococci (CNS) isolates were obtained from 169 specimens belonging to patients with inflammatory acne vulgaris and the antimicrobial susceptibilities of these isolates against nadifloxacin, erythromycin, clindamycin and tetracycline were determined at the minimum inhibitory concentration levels, using the 'Clinical and Laboratory Standards Institute' agar dilution method. Results: There were no P. acnes isolate resistant to the antibiotics tested in this study and the antibiotic resistance status among CNS was as 28%, 36%, 23% and 0% for tetracycline, erythromycin, clindamycine and nadifloxacin, respectively. Conclusion: According to the results of this study, it may be expected that nadifloxacin could be more effective in the treatment of acne than other antimicrobial agents because of having no resistance to both P. acnes and CNS. However, this must be supported by clinical trials. Although resistance rates were found to be relatively low in this study, the antibiotic resistance problem should be taken into consideration while planning a treatment to get successful results. In case of treatment failures, presence of drug resistant strains should be considered. Keywords: Antibiotic resistance, topical, acne, İstanbul Amaç: Akne vulgaris, inflame lezyonların patogenezinde Propionibacterium acnes'in önemli bir rol oynadığı düşünülen multifaktöriyel bir hastalıktır. Ayrıca stafilokokların da akne vulgariste olası patogenetik rolü olduğuna dair önemli in vitro bulgular vardır. Yapılan bir çalışmada, akne açısından değerlendirilen katılımcıların %53'ünün Staphylococcus epidermidis ile kolonize olduğu gösterilmiştir. Gereç ve Yöntem: Bu çalışmada enflamatuvar akneli hastalardan sağlanan 169 örnekten, 29 P. acnes ve 61 koagülaz negatif stafilokok (KNS) izolatı elde edilmiş ve bu izolatların nadifloksasin, eritromisin, klindamisin ve tetrasikline karşı antimikrobiyal duyarlılıkları Klinik ve Laboratuvar Standartları Kurumu 'Clinical and Laboratory Standards Institute' agar dilüsyon metodu kullanılarak minimum inhibisyon konsantrasyonu seviyesinde belirlenmiştir. Bulgular: Hiçbir P. acnes izolatı bu çalışmada kullanılan antibiyotiklere dirençli değildi. KNS izolatlardaki direnç durumu ise tetrasiklin, eritromisin, klindamisin ve nadifloksasine karşı sırasıyla %28, %36, %23 ve %0 olarak saptandı. Sonuç: Bu çalışma verilerine göre, nadifloksasine karşı P. acnes ve KNS izolatlarında herhangi bir direnç saptanmaması nedeniyle, nadifloksasinin akne tedavisinde daha etkili olabileceği düşünülebil...

Role of topical nadifloxacin as an empirical treatment in patients with skin and soft-tissue infections in India: A review and consensus

“…When the effectiveness of Nadifloxacin, Erythromycin, Clindamycin, and Tetracycline against P. acnes and CNS isolates from inflammatory lesions were compared, the MIC for Nadifloxacin was ≤1 µg/mL and resistance was shown at MIC level ≥4 µg/mL. [58] Compared to Ciprofloxacin, Erythromycin, and Clindamycin, Nadifloxacin demonstrated better activity against P. acnes as the MIC50 and MIC90 values were lesser compared to those of other antimicrobials. [45] Biswal et al (2016) demonstrated that the MIC50 and MIC90 values for Nadifloxacin (0.25 and 1µg/ mL) were lower than those for Ciprofloxacin (0.5 and 1µg/ mL).…”