Abstract

Background: Cutibacterium acnes (C. acnes) is one of the normal microbiotas found inside the sebaceous glands that shifts to an opportunistic pathogen and causes acne. Recently, the antibiotic resistance of C. acnes has become a major concern in dermatology clinics due to microbiome dysbiosis the bacterial ability to form biofilms.
Aim: to evaluate the biofilm profile of different phylotypes of C. acnes isolated from acne patients and a healthy control and to assess the minimum inhibitory concentration (MIC) for commonly used antibiotics in acne treatment.
Materials and Methods: From February to June 2024, a study was conducted in Basrah, Iraq, at the Basrah teaching hospital, involving 70 acne patients (mean ±SD: 18 ±2 years) and 70 healthy controls. We performed swab sampling from the face's surface and sent it for molecular detection and phylotyping of C. acnes. Subsequently, biofilm formation and MIC testing against several antibiotics were evaluated.
Results: Results: For acne patients, C acnes was isolated from 37 out of 70 samples and IA-2 was the predominant phylotypes, while healthy controls samples showed more divers bacterial clades (IA-2, IB, and II.). C acnes isolated from patient’s samples showed multiple resistance towards clindamycin, erythromycin, and levofloxacin, while sensitivity was higher for azithromycin and doxycycline. Biofilm formations were observed in both patients and control isolates; however, the healthy control samples exhibited a statistically lower biofilm concentration compared to acne patients.
Conclusion: This study highlights that specific C. acnes strains are key contributors to the development of acne. Furthermore, the observed rise in antimicrobial resistance among isolated strains underscores the consequences of antibiotic misuse and emphasizes the urgent need to reconsider current treatment approaches by replacing antibiotics with alternatives that would restore the C. acnes phylotype diversity and break down bacterial biofilms.