title: MLST typing of antimicrobial-resistant Propionibacterium acnes isolates from patients with moderate to severe acne vulgaris.
abstract: Molecular typing data on antimicrobial-resistant Propionibacterium strains are limited in the literature. We examined antimicrobial resistance profiles and the underlying resistance mechanisms in Propionibacterium spp. isolates recovered from patients with moderate to severe acne vulgaris in Greece. The clonallity of the resistant Propionibacterium acnes isolates was also investigated. Propionibacterium spp. isolates were detected using Tryptone-Yeast Extract-Glucose (TYG) agar plates supplemented with 4% furazolidone. Erythromycin, clindamycin, vancomycin, penicillin, co-trimoxazole, doxycycline, minocycline and ciprofloxacin MICs were determined using the gradient strip method. Erythromycin, clindamycin and tetracycline mechanisms of resistance were determined using PCR and sequencing of the domain V of 23S rRNA and 16S rRNA, as well as the presence of the ermX gene. Typing was performed using the multi locus sequence typing (MLST) methodology. Seventy nine isolates from 76 patients were collected. Twenty-three isolates (29.1%) exhibited resistance to erythromycin and clindamycin, while two additional isolates (2.5%) were resistant only to erythromycin. Resistance to tetracycline was not detected. The underlying molecular mechanisms were point mutations A2059G and A2058G. MLST typing of the P. acnes resistant isolates revealed that lineage type IA1 (ST-1, 3 and 52) prevailed (12/18; 66.7%), whilst lineage type IA2 (ST-2 and 22) accounted for five more isolates (27.8%). Susceptible isolates were more evenly distributed between ST types. Propionibacterium spp. from moderate to severe acne vulgaris in Greece are frequently resistant to erythromycin/clindamycin but not to tetracyclines, mainly due to the point mutations A2059G and A2058G. P. acnes resistant isolates were more clonally related than susceptible ones and belonged to a limited number of MLST types.
authors.affiliation: Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece; Department of Dermatology, "Attikon" University Hospital, Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Lambros
authors.initials: L
authors.lastname: Giannopoulos
authors.affiliation: Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece. Electronic address: ipapapar@med.uoa.gr.
authors.forename: Joseph
authors.initials: J
authors.lastname: Papaparaskevas
authors.affiliation: Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece.
authors.forename: Eirini
authors.initials: E
authors.lastname: Refene
authors.affiliation: First Department of Propaedeutic Internal Medicine, "Laikon" University Hospital, Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Daikos
authors.affiliation: Department of Dermatology, "Attikon" University Hospital, Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Stavrianeas
authors.affiliation: Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece.
authors.forename: Athanassios
authors.initials: A
authors.lastname: Tsakris
mesh_terms: D000152:Acne Vulgaris / Q000453:epidemiology / Q000382:microbiology*; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016000:Cluster Analysis; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D024881:Drug Resistance, Bacterial; D005838:Genotype; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008826:Microbial Sensitivity Tests; D058885:Multilocus Sequence Typing; D017354:Point Mutation; D016133:Polymerase Chain Reaction; D015995:Prevalence; D011425:Propionibacterium acnes / Q000145:classification* / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012338:RNA, Ribosomal, 23S / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D004275:DNA, Ribosomal; D012336:RNA, Ribosomal, 16S; D012338:RNA, Ribosomal, 23S
keywords: Clindamycin; Erythromycin; MLST; Propionibacterium acnes; Resistance; Tetracycline