Perfil bacteriológico en pacientes con acné

El acné es un motivo frecuente de consulta en Atención primaria y en Dermatología, el conocimiento del perfil bacteriológico del mismo junto al microbioma puede conllevar una mejoría en la aproximación terapéutica al mismo. El acné se considera una enfermedad crónica de tipo inflamatorio en la que juegan un papel importante Cutibacterium acnes (C. acnes), una bacteria anaerobia Gram positiva, la glándula sebácea y el epitelio de la unidad pilosebácea. La ausencia de estudios concluyentes acerca del papel del microbioma en el acné y las repercusiones del mismo en su patogénesis motivaron a la realización de este trabajo. En este estudio profundizamos en el conocimiento del perfil bacteriológico de los pacientes con acné, el papel del microbioma y su interés en el abordaje terapéutico de los mismos. Además, realizamos un estudio del perfil bacteriológico de un grupo de pacientes con acné atendidos en nuestra área sanitaria. Dentro del grupo de 34 pacientes que fueron estudiados por acné en una consulta del área Oeste de Valladolid, que aceptaron formar parte del estudio, los resultados del estudio microbiológico fueron los siguientes: La cepa bacteriana más frecuentemente aislada fue Staphylococcus epidermidis (S. epidermidis) en un 64,5% de los casos, seguido de C. acnes en el 47.1%. En dos casos de acné fulminans se observó crecimiento de Staphylococcus haemolyticus (S. haemolyticus) y Staphylococcus hominis (S. hominis).Grado en Medicin

Interaction of Cutibacterium (formerly Propionibacterium) acnes with bone cells: a step toward understanding bone and joint infection development

Cutibacterium acnes (formerly Propionibacterium acnes) is recognized as a pathogen in foreign-body infections (arthroplasty or spinal instrumentation). To date, the direct impact of C. acnes on bone cells has never been explored. The clade of 11 C. acnes clinical isolates was determined by MLST. Human osteoblasts and osteoclasts were infected by live C. acnes. The whole genome sequence of six isolates of this collection was analyzed. CC36 C. acnes strains were significantly less internalized by osteoblasts and osteoclasts than CC18 and CC28 C. acnes strains (p ≤ 0.05). The CC18 C. acnes ATCC6919 isolate could survive intracellularly for at least 96 hours. C. acnes significantly decreased the resorption ability of osteoclasts with a major impact by the CC36 strain (p ≤ 0.05). Genome analysis revealed 27 genes possibly linked to these phenotypic behaviors. We showed a direct impact of C. acnes on bone cells, providing new explanations about the development of C. acnes foreign-body infections

MALDI-TOF mass spectrometry misidentification of <i>Cutibacterium namnetense</i> and <i>Cutibacterium modestum</i>: Implications for multiplex PCR phylotyping of <i>Cutibacterium acnes</i>

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) can misidentify Cutibacterium namnetense and Cutibacterium modestum as Cutibacterium acnes. We now describe how such MALDI-TOF MS misidentification explains previous reports of C. acnes isolates that could not be characterised using a multiplex PCR phylotyping assay

Uji Aktivitas Antibakteri Ekstrak Etanol Sabut Kelapa (Cocos nucifera Linn.) Terhadap Bakteri Cutibacterium acnes

Cutibacterium acnes is the main bacteria that causes acne. Acne is a skin infection that is common and often complained about. Acne is an obstructive skin disease and chronic inflammation of the pilosebaceous glands, which is characterized by the appearance of comedones, papules, pustules and nodules. Treatment of acne can be done with the help of antibiotics. However, continuous use of antibiotics can cause resistance. This study aims to test the antibacterial activity by using natural ingredients, namely ethanol extract of coconut husk (Cocos nucifera L.) against Cutibacterium acnes. The study was carried out by extracting coconut husk simplicia using maceration method using 96% ethanol solvent. From the extraction results obtained, the antibacterial activity was then tested using the well diffusion method. The results obtained were that the ethanol extract of coconut husk contained tannins, flanonoids, saponins and terpenoids. The results of the antibacterial activity test showed that 7.5% coconut husk ethanol extract produced an inhibitory zone diameter of 7.05 mm, 10% extract produced an inhibitory zone diameter of 13.05 mm, and 12.5% extract produced an inhibitory zone diameter of 14 . 15 mm with strong antibacterial properties

A novel combinatorial approach for the Identification of Cutibacterium namnetense and Cutibacterium modestum from Facial Acne Samples

Background:  Cutibacterium spp. is one of the most understudied bacteria and this is owed to its slow growing nature and its stringent requirement for anoxic conditions. To date, shortgun metagenomic sequencing and MALDI-TOF MS are widely used for species detection but, the latter is not able to distinguish C. acnes from C. modestum and C. namnetense. Our study has innovatively combined colony morphology, biochemical assays and16s rRNA gene sequencing to identify C. acnes as well as the underreported C. namnetense and C. modestum from facial clinical acne samples.Methods: The clinical samples were obtained using a non-invasive method from acne patients at the Dermatology Clinic of Hospital Tuanku Jaafar, Seremban, Malaysia between January 2022 to December 2022. Colonies of Cutibacterium spp. were screened on BHI agar followed by subjecting them to the catalase and indole tests. The isolates were verified as Cutibacterium spp. using API20A and 16s rRNA Sanger gene sequencing.Result: Out of 68 Cutibacterium spp. isolates, 3 were identified as C. modestum and 1 as C. namnetense while the rest were C. acnes. All isolates were present as raised, white colonies with 0.03 to 1mm in diameter on BHI agar. 89.71% of these isolates were indole producers. All isolates were identified as C. acnes in API20A but, the 16srRNA gene sequencing revealed 4 isolates as C. modestum and C. namnetense.Conclusion: This study is the first to report the isolation of C. namnetense and C. modestum in clinical facial acne samples from Malaysia and across Asia, employing a modified combination of morphological, biochemical, and 16srRNA gene analyses. This methodical yet straightforward approach serves as a viable alternative in research settings lacking access to advanced techniques like MALDI-TOF and shotgun metagenomic sequencing. Moreover, this conventional isolation approach is valuable in assessing the sensitivity of the isolates to inhibitory agents apart from antibiotics, expanding researchers' abilities to develop potent antibacterial agents required for human health and wellbeing.Keywords:  Acne; Clinical Samples; Combinatorial; Identification

Culture of periprosthetic tissue in blood culture bottles for diagnosing periprosthetic joint infection

Background: The purpose of this meta-analysis was to evaluate the diagnostic accuracy of periprosthetic tissue culture in blood culture bottles (BCB) for periprosthetic joint infection (PJI). Methods: PubMed, Web of Science, and Embase were systematically searched for eligible studies evaluating the diagnostic performance of periprosthetic tissue culture in BCB for the diagnosis of PJI. The pooled data were analysed by Meta-Disc software. Results: Four studies with a total of 1071 patients were included in this meta-analysis. The summarized estimates showed that periprosthetic tissue culture in BCB may be of great value in PJI diagnosis with a pooled sensitivity of 0.70 (95% confidence interval [CI]; 0.66–0.75), specificity of 0.97 (95% CI: 0.95–0.98); positive likelihood ratio (PLR) of 20.98 (95% CI: 11.52–38.2); negative likelihood ratio (NLR) of 0.28 (95% CI: 0.20–0.40); and diagnostic odds ratio (DOR) of 92.26 (95% CI: 43.93–193.78). Conclusions: The present meta-analysis showed that periprosthetic tissue in BCB improves the results of microorganism cultures, with a sensitivity of 70% and a specificity of 97%. However, more large-scale, well-performed studies are needed to verify our findings

True infection or contamination in patients with positive Cutibacterium blood cultures-a retrospective cohort study

Cutibacterium is a genus often considered a contaminant when present in blood cultures, but it can also cause severe infections, especially related to implanted foreign materials. We investigated the incidence and features of patients with true Cutibacterium infection. Patients with positive Cutibacterium blood cultures between the years 2015-2020 in southern Sweden were identified through microbiology records and medical records were studied retrospectively. Cutibacterium isolates were species determined using MALDI-TOF MS. Patients were classified as having true infection or contamination according to a definition considering both clinical and microbiological features and these groups were compared. A total of 313 episodes of positive Cutibacterium blood cultures were identified in 312 patients. Of these, 49 (16%, corresponding to an incidence of 6 cases per million inhabitants per year) were classified as true infections. The most common species was Cutibacterium acnes (87%), and the majority were elderly men with comorbidities. Patients with true Cutibacterium infection often had an unknown focus of infection (n = 21) or a focus in the respiratory tract (n = 18). We identified one episode of ventriculo-peritoneal shunt infection, three episodes of aortic stent-graft infection, and one episode of infective endocarditis. Two patients, where Cutibacterium was isolated at the site of infection, had only one positive blood culture. The finding of positive Cutibacterium blood cultures should not always be considered contamination. Definitions of true Cutibacterium bacteremia with a demand that more than one blood culture must be positive may miss true infections

Skin dysbiosis and Cutibacterium acnes biofilm in inflammatory acne lesions of adolescents

Acne vulgaris is a common inflammatory disorder affecting more than 80% of young adolescents. Cutibacterium acnes plays a role in the pathogenesis of acne lesions, although the mechanisms are poorly understood. The study aimed to explore the microbiome at different skin sites in adolescent acne and the role of biofilm production in promoting the growth and persistence of C. acnes isolates. Microbiota analysis showed a significantly lower alpha diversity in inflammatory lesions (LA) than in non-inflammatory (NI) lesions of acne patients and healthy subjects (HS). Differences at the species level were driven by the overabundance of C. acnes on LA than NI and HS. The phylotype IA1 was more represented in the skin of acne patients than in HS. Genes involved in lipids transport and metabolism, as well as potential virulence factors associated with host-tissue colonization, were detected in all IA1 strains independently from the site of isolation. Additionally, the IA1 isolates were more efficient in early adhesion and biomass production than other phylotypes showing a significant increase in antibiotic tolerance. Overall, our data indicate that the site-specific dysbiosis in LA and colonization by virulent and highly tolerant C. acnes phylotypes may contribute to acne development in a part of the population, despite the universal carriage of the microorganism. Moreover, new antimicrobial agents, specifically targeting biofilm-forming C. acnes, may represent potential treatments to modulate the skin microbiota in acne

Implant sonication versus intraoperative tissue sample cultures for periprosthetic joint infection (PJI) of shoulder arthroplasty

Introduction: Periprosthetic joint infection (PJI) is the most problematic complications after shoulder arthroplasty. Many diagnostic tools have been identified to find infection, such as hystopatologic examination of tissue sections or cultures of intraoperative tissue. Implant sonication fluid culture showed good results in order to enhance diagnostic accuracy, but literature results are still controversial. Aim of our study is to compare the results of sonication with intraoperative tissue sample cultures. Patients and Methods: From February 2016 to January 2018 we performed 102 revisions of Total Shoulder Arthroplasty (TSA) for suspected PJI. Sixty-five patients respected the criteria for admission to the study and were enrolled. In each case periprostethic specimens were collected and explanted prosthesis were put inside sterile fluid, sonicated and then placed under culture. Results: Among the sixty-five patients, 36 were considered as possible, probable or certain infection. Tissue cultures were positive for infection in thirty-four cases (52,3%) and in nineteen cases was found the positivity for Cutibacterium acnes. Sonication fluid cultures were positive in forty cases (61,5%), with a positivity for Cutibacterium acnes in twenty-seven cases. The sensitivities of sonication and tissue cultures for the diagnosis of shoulder PJI were 83.3% and 88,9% (P = 0,08); the specificities were 65.5% and 93,1% (P &lt; 0.01) respectively. Conclusion: Our results suggest that sonication technique had not shown a clear advantage in postoperative shoulder PJI diagnosis, but it’s a real aid to detect Cutibacterium acnes. In any case, sensitivity and mostly specificity were higher with tissue cultures. (www.actabiomedica.it)