Prevalence of Multidrug Resistance of Cutibacterium acnes Isolated from Micro-comedone Specimen

Abstract

Cutibacterium acnes, a Gram-positive anaerobic bacterium, has long been associated with human skin as a commensal organism. However, it has been implicated in various dermatological conditions, most notably acne vulgaris.  Nowadays, C. acnes is becoming resistant to various antibiotic groups. This study aimed to determine the prevalence of multidrug resistant C. acnes (MDR C. acnes) and a relationship between variable factors and prevalence of MDR C. acnes isolated from micro-comedone.  C. acnes were isolated from 46 volunteers at mild and moderate stages of acne. The isolates were cultured on blood agar under anaerobic conditions and identified by using biochemical test. Antibiotic susceptibility test was conducted using antimicrobial gradient strips (the E-test method). The relationship between MDR prevalence and other variable factors was examined using the chi-square test. The results revealed that MDR C. acnes was identified in 20% of cases, with 9% showing resistance to clindamycin, erythromycin, and gentamicin, and 11% exhibiting resistance to clindamycin, erythromycin, and tetracycline. MDR C. acne was found more frequently in individuals with moderate-severity acne compared to those with mild-severity acne, with statistical significance (p < 0.05). In individuals with oily facial skin, the presence of MDR C. acne was higher than in those with other skin types (p < 0.05). Additionally, individuals who used topical antibiotics and did not adhere to the prescribed antibiotic regimen by their doctor had a higher incidence of MDR C. acne compared to other groups (p < 0.05). Therefore, in the treatment of acne with antibiotics, it is crucial to emphasize treatment adherence and provide patients with information about using antibiotics according to the prescribing doctor's recommendations. This is to reduce the development of antibiotic resistance and minimize the severity of acne.