Frontiers in Public Health (Mar 2022)

C. acnes qPCR-Based Antibiotics Resistance Assay (ACQUIRE) Reveals Widespread Macrolide Resistance in Acne Patients and Can Eliminate Macrolide Misuse in Acne Treatment

  • Jingheng Zhang,
  • Fang Yu,
  • Keyun Fu,
  • Xinyu Ma,
  • Yi Han,
  • Chi Ching Ali,
  • Haonan Zhou,
  • Yantao Xu,
  • Yantao Xu,
  • Tingyue Zhang,
  • Shuntong Kang,
  • Yiming Xu,
  • Zhuolin Li,
  • Jiaqi Shi,
  • Shuai Gao,
  • Yongyi Chen,
  • Yongyi Chen,
  • Liyu Chen,
  • Jianglin Zhang,
  • Jianglin Zhang,
  • Jianglin Zhang,
  • Feizhou Zhu,
  • Feizhou Zhu,
  • Feizhou Zhu

DOI
https://doi.org/10.3389/fpubh.2022.787299
Journal volume & issue
Vol. 10

Abstract

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BackgroundMacrolides have been widely used to treat moderate-to-severe acne for more than 50 years. However, the prevalent antibiotic resistance of Propionibacterium acnes, along with the absence of clinically available resistance tests, has made macrolide misuse a frequent occurrence around the globe, with serious consequences.ObjectiveWe developed Cutibacterium acnes quantitative PCR (qPCR)-based antibiotics resistance assay (ACQUIRE) to enable fast and accurate detection of C. acnes macrolide resistance in clinical settings, representing an opportunity to administer antibiotics more wisely and improve the quality of care.MethodsA cross-sectional observational study (n = 915) was conducted to probe into the macrolide resistance of C. acnes in patients with acne.ResultsThe high sensitivity of ACQUIRE enabled us to reveal a much higher C. acnes 23S recombinant DNA (rDNA) point mutation rate (52%) and thus a higher macrolide resistance (75.5%) compared to previous reports. Carriage of ermX gene was discovered on 472 (53%) subjects, which concurs with previous studies.ConclusionThe macrolide resistance of C. acnes is much higher than previously reported. Integrating ACQUIRE into acne treatment modalities may eliminate macrolide misuse and achieve better clinical improvements.

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