AUTHOR=Zhang Jingheng , Yu Fang , Fu Keyun , Ma Xinyu , Han Yi , Ali Chi Ching , Zhou Haonan , Xu Yantao , Zhang Tingyue , Kang Shuntong , Xu Yiming , Li Zhuolin , Shi Jiaqi , Gao Shuai , Chen Yongyi , Chen Liyu , Zhang Jianglin , Zhu Feizhou TITLE=C. acnes qPCR-Based Antibiotics Resistance Assay (ACQUIRE) Reveals Widespread Macrolide Resistance in Acne Patients and Can Eliminate Macrolide Misuse in Acne Treatment JOURNAL=Frontiers in Public Health VOLUME=10 YEAR=2022 URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.787299 DOI=10.3389/fpubh.2022.787299 ISSN=2296-2565 ABSTRACT=Background

Macrolides 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.

Objective

We 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.

Methods

A cross-sectional observational study (n = 915) was conducted to probe into the macrolide resistance of C. acnes in patients with acne.

Results

The 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.

Conclusion

The 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.