The Aerobic and Anaerobic Microbiology of Pustular Acne Lesions

Antimicrobial activities encountered by sulfur nanoparticles combating Staphylococcal species harboring sccmecA recovered from acne vulgaris

Over decades, sulfur has been employed for treatment of many dermatological diseases, several skin and soft tissue, and Staphylococcus infections. Because of its abuse, resistant bacterial strains have emerged. Nanotechnology has presented a new horizon to overcome abundant problems including drug resistance. Nano-sized sulfur has proven to retain bactericidal activity. Consequently, the specific aims of this study are exclusively directed to produce various sulfur nanoparticles formulations with control of particle size and morphology and investigate the antibacterial activity response specifically classified by the category of responses of different formulations, for the treatment of acne vulgaris resistant to conventional antibiotics. In this study, we produced uncoated sulfur nanoparticles (SNPs), sulfur nano-composite with chitosan (CS-SNPs), and sulfur nanoparticles coated with polyethylene glycol (PEG-SNPs) and evaluate their bactericidal impact against Staphylococcus aureus and Staphylococcus epidermidis isolated from 173 patients clinically diagnosed acne vulgaris. Accompanied with molecular investigations of ermB and mecA resistance genes distribution among the isolates. Sulfur nanoparticles were synthesized using acid precipitation method and were characterized by scanning electron microscope (SEM), transmission electron microscopy (TEM), energy dispersed x-ray spectroscopy (EDX), and Fourier transform infrared spectroscopy (FTIR). Moreover, agar diffusion and broth micro-dilution methods were applied to determine their antibacterial activity and their minimum inhibitory concentration. PCR analysis for virulence factors detection. Results: TEM analysis showed particle size of SNPs (11.7 nm), PEG-SNPs (27 nm) and CS-SNPs (33 nm). Significant antibacterial activity from nanoparticles formulations in 100% dimethyl sulfoxide (DMSO) with inhibition zone 30 mm and MIC at 5.5 µg/mL. Furthermore, the prevalence of mecA gene was the most abundant among the isolates while ermB gene was infrequent. Conclusions: sulfur nanoparticles preparations are an effective treatment for most Staphylococcus bacteria causing acne vulgaris harboring multi-drug resistance virulence factors.

Differences of Microbiomes Found in Non-Inflammatory and Inflammatory Lesions of Acne Vulgaris

Purpose

Bacterial activity and inflammation both influence acne vulgaris (AV) formation. Cutibacterium acnes is considered as an actor involved in inflammation of AV. Besides Cutibacterium acnes, other microbiomes found in AV may also play a role in the pathogenesis. This research was conducted to overview microbiomes found in non-inflammatory and inflammatory lesions of AV.

Patients and Methods

An observational descriptive study with cross-sectional approach was designed. Sample collection was performed with 40 subjects with AV. In every patient, both non-inflammatory (closed comedone) and inflammatory (pustule) lesion samples were collected by swab. Afterward, bacterial culture was performed, continued by bacterial identification.

Results

In non-inflammatory lesions, the growth of nine bacterial species was observed from 40 samples. In an anaerobic culture, Cutibacterium acnes (17,5%) was identified. In aerobic cultures, different bacterial species were found including Staphylococcus epidermis (52.5%), Staphylococcus hominis (12.5%), Staphylococcus haemolyticus (7.5%), Micrococcus luteus (7.5%), Leuconostoc mesentroides (7.5%), Staphylococcus aureus (5%), Kocuria varians (5%), and Staphylococcus vitulinus (2.5%). In inflammatory lesions, nine bacterial species were found, in which was the anaerobic culture we identified Cutibacterium acnes (25.0%). Aerobic cultures have revealed the growth colonies of Staphylococcus epidermidis (42.5%), Staphylococcus hominis (22.5%), Staphylococcus aureus (12.5%), Staphylococcus haemolyticus (10.0%), Leuconostoc mesentroides (5.0%), Staphylococcus cohnii (2.5%), Staphylococcus arlettae (2.5%), and Dermacoccus nishinomyaensis (2.5%). Two mixed bacterial growths were observed in non-inflammatory lesions, while four mixed bacterial growths were found in inflammatory lesions.

Conclusion

Differences in bacterial isolates were observed both in non-inflammatory and inflammatory lesions of AV.

Surgical Site Infections in Pediatric Spine Surgery: Comparative Microbiology of Patients with Idiopathic and Nonidiopathic Etiologies of Spine Deformity

BACKGROUND

Surgical site infections (SSIs) are a concern in pediatric spine surgery with unusually high rates for a clean surgery and especially for patients with deformity of nonidiopathic etiology. Microbiologic differences between etiologies of spine deformities have been poorly investigated.

METHODS

We reviewed all cases of SSI in spinal surgery between 2007 and 2011. Characteristics of cases and of bacteria according to the etiology of the spine disease were investigated.

RESULTS

Of 496 surgeries, we identified 51 SSIs (10.3%) in 49 patients. Staphylococcus aureus was the most frequent pathogen whatever the etiology (n = 31, 61% of infection cases). The second most frequent pathogens vary according to the etiology of the spine deformity. It was Gram-negative bacilli (GNB) in nonidiopathic cases (n = 19, 45% of cases) and anaerobe in idiopathic cases (n = 8, 38% of cases), particularly Gram-positive anaerobic cocci (n = 5, 24% of cases). Infection rate was 6.8% in cases with idiopathic spine disease (n = 21) and 15.9% in cases with nonidiopathic spine disease (n = 30). Nonidiopathic cases were more frequently male with lower weight. American Society of Anesthesiologists score was more often greater than 2, they had more frequently sacral implants and postoperative intensive care unit stay. GNB were significantly associated with a nonidiopathic etiology, low weight, younger age and sacral fusion. SSIs were polymicrobial in 31% of cases with a mean of 1.4 species per infection cases.

CONCLUSION

S. aureus is the first cause of SSI in pediatric spine surgery. However, Gram-positive anaerobic cocci should be taken into account in idiopathic patients and GNB in nonidiopathic patients when considering antibiotic prophylaxis and curative treatment.

The role of anaerobic bacteria in cutaneous and soft tissue abscesses and infected cysts

This review presents the aerobic and anaerobic microbiological aspects and management of cutaneous and soft tissue abscesses, paronychia, anorectal, pilonidal, and perirectal abscesses, infected epidermal cysts, hidradenitis suppurativa, and pustular acne lesions. These infections often occur in different body sites or in areas that have been compromised or injured by foreign body, trauma, ischemia, malignancy or surgery. In addition to group A beta-hemolytic streptococci and Staphylococcus aureus, the indigenous aerobic and anaerobic cutaneous and mucous membranes local microflora usually is responsible for these generally polymicrobial infections. These infections may occasionally lead to serious potentially life-threatening local and systemic complications. The infections can progress rapidly and early recognition and proper medical and surgical management is the cornerstone of therapy.