Editing Cutibacterium acnes

{{Short description|Species of bacterium}}
{{speciesbox
| image = Propionibacterium acnes.jpg
| taxon = Cutibacterium acnes
| authority = Scholz and Kilian, 2016<ref name="DSMZ"/><ref name="Scholz"/>
| subdivision_ranks = Subspecies
| subdivision =
* ''[[Cutibacterium acnes subsp. acnes|subsp. acnes]]''
* ''[[Cutibacterium acnes subsp. defendens|subsp. defendens]]''
* ''[[Cutibacterium acnes subsp. elongatum|subsp. elongatum]]''<ref name="Dréno"/>
| synonyms =
* "''Bacillus acnes''" <small>Gilchrist 1900</small>
* ''Propionibacterium acnes'' <small>(Gilchrist 1900) Douglas and Gunter 1946 (Approved Lists 1980)</small>
}}

'''''Cutibacterium acnes''''' ('''''Propionibacterium acnes''''')<ref name="DSMZ">{{cite web |title=Genus: Cutibacterium |url=https://www.dsmz.de/microorganisms/pnu/bacterial_nomenclature_info_mm.php?genus=Cutibacterium&show_all_details=1 |website=Prokaryotic Nomenclature Up-to-Date |publisher=DSMZ |access-date=17 August 2018 |archive-url=https://web.archive.org/web/20180817193425/https://www.dsmz.de/microorganisms/pnu/bacterial_nomenclature_info_mm.php?genus=Cutibacterium&show_all_details=1 |archive-date=17 August 2018 }}</ref><ref name="Scholz">{{cite journal | vauthors = Scholz CF, Kilian M | title = The natural history of cutaneous propionibacteria, and reclassification of selected species within the genus Propionibacterium to the proposed novel genera Acidipropionibacterium gen. nov., Cutibacterium gen. nov. and Pseudopropionibacterium gen. nov | journal = International Journal of Systematic and Evolutionary Microbiology | volume = 66 | issue = 11 | pages = 4422–4432 | date = November 2016 | pmid = 27488827 | doi = 10.1099/ijsem.0.001367 | url = http://www.microbiologyresearch.org/docserver/fulltext/ijsem/66/11/4422_ijsem001367.pdf?expires=1534521507&id=id&accname=guest&checksum=B23A8B3A726C1F800627847E3280A9A2 | access-date = 17 August 2018 | doi-access = free }}</ref><ref name="Dréno">{{cite journal | vauthors = Dréno B, Pécastaings S, Corvec S, Veraldi S, Khammari A, Roques C | title = Cutibacterium acnes (Propionibacterium acnes) and acne vulgaris: a brief look at the latest updates | journal = Journal of the European Academy of Dermatology and Venereology | volume = 32 | pages = 5–14 | date = June 2018 | issue = Suppl 2 | pmid = 29894579 | doi = 10.1111/jdv.15043 | doi-access = free | hdl = 2434/620522 | hdl-access = free }}</ref><ref name="LPSN">{{cite web |title=Genus Cutibacterium |url=https://lpsn.dsmz.de/genus/cutibacterium |website=LPSN |access-date=17 August 2018}}</ref> is the relatively slow-growing, typically [[aerotolerant]] [[Anaerobic organism|anaerobic]], [[gram-positive]] [[bacterium]] (rod) linked to the [[skin]] condition of [[acne vulgaris|acne]];<ref name="Bhatia2004">{{Cite book|url=https://www.ncbi.nlm.nih.gov/books/NBK83685/|title=Proprionibacterium acnes and Chronic Diseases| vauthors = Bhatia A, Maisonneuve JF, Persing DH |date=2004-01-01|publisher=National Academies Press (US)|language=en}}</ref> it can also cause chronic [[blepharitis]] and [[endophthalmitis]],<ref name="autogenerated1">{{cite journal | vauthors = Dali P, Giugliano ER, Vellozzi EM, Smith MA | title = Susceptibilities of Propionibacterium acnes ophthalmic isolates to moxifloxacin | journal = Antimicrobial Agents and Chemotherapy | volume = 45 | issue = 10 | pages = 2969–70 | date = October 2001 | pmid = 11583007 | pmc = 90767 | doi = 10.1128/AAC.45.10.2969-2970.2001 }}</ref> the latter particularly following [[intraocular surgery]]. Its [[genome]] has been sequenced and a study has shown several [[gene]]s can generate [[enzyme]]s for degrading [[skin]] and [[protein]]s that may be immunogenic (activating the [[immune system]]).<ref>{{cite journal | vauthors = Liu J, Cheng A, Bangayan NJ, Barnard E, Curd E, Craft N, Li H | title = Draft Genome Sequences of Propionibacterium acnes Type Strain ATCC6919 and Antibiotic-Resistant Strain HL411PA1 | journal = Genome Announcements | volume = 2 | issue = 4 | pages = e00740–14 | date = August 2014 | pmid = 25125638 | pmc = 4132614 | doi = 10.1128/genomeA.00740-14 }}
</ref>

The species is largely [[commensalism|commensal]] and part of the [[skin flora]] present on most healthy adult humans' skin.<ref>{{cite journal | vauthors = Brüggemann H, Henne A, Hoster F, Liesegang H, Wiezer A, Strittmatter A, Hujer S, Dürre P, Gottschalk G | display-authors = 6 | title = The complete genome sequence of Propionibacterium acnes, a commensal of human skin | journal = Science | volume = 305 | issue = 5684 | pages = 671–3 | date = July 2004 | pmid = 15286373 | doi = 10.1126/science.1100330 | s2cid = 26252335 | bibcode = 2004Sci...305..671B }}</ref>  It is usually just barely detectable on the skin of healthy preadolescents.  It lives, among other things, primarily on [[fatty acid]]s in [[sebum]] secreted by sebaceous glands in the [[Hair follicle|follicle]]s. It may also be found throughout the [[gastrointestinal tract]].<ref name="expert-reviews2003">{{cite journal | vauthors = Perry A, Lambert P | title = Propionibacterium acnes: infection beyond the skin | journal = Expert Review of Anti-Infective Therapy | volume = 9 | issue = 12 | pages = 1149–56 | date = December 2011 | pmid = 22114965 | doi = 10.1586/eri.11.137 | s2cid = 42012357 }}</ref>

Originally identified as ''Bacillus acnes'',<ref name="Gilchrist">{{cite journal |  vauthors = Gilchrist TC |title=A bacteriological and microscopical study of over 300 vesicular and pustular lesions of the skin, with a research upon the etiology of acne vulgaris |journal=Johns Hopkins Hospital Report |date=1900 |volume=9 |pages=409–430 }}</ref> it was later named ''Propionibacterium acnes'' for its ability to generate [[propionic acid]].<ref name="Douglas">{{cite journal | vauthors = Douglas HC, Gunter SE | title = The Taxonomic Position of Corynebacterium acnes | journal = Journal of Bacteriology | volume = 52 | issue = 1 | pages = 15–23 | date = July 1946 | pmid = 16561149 | pmc = 518134 | doi = 10.1128/JB.52.1.15-23.1946 | url = }}</ref> In 2016, ''P. acnes'' was taxonomically reclassified as a result of biochemical and genomic studies. In terms of both [[phylogenetic tree]] structure and DNA G + C content, the cutaneous species was distinguishable from other species that had been previously categorized as ''P. acnes''.<ref name="Scholz"/><ref>{{cite web |title=Propionibacterium Cutibacterium - late breaking news and a new name |url=http://shoulderarthritis.blogspot.com/2017/04/propionibacterium-cutibacterium-late.html |website=Shoulder Arthritis / Rotator Cuff Tears: causes of shoulder pain |access-date=17 August 2018|date= April 2, 2017}}</ref>  As part of restructuring, the novel genus ''Cutibacterium'' was created for the cutaneous species,<ref name="Scholz"/> including those formerly identified as ''Propionibacterium acnes'', ''[[Propionibacterium avidum]]'', and ''[[Propionibacterium granulosum]]''.<ref name="DSMZ"/> Characterization of phylotypes of ''C. acnes'' is an active field of research.<ref name="Dréno"/><ref name="Dagnelie">{{cite journal | vauthors = Dagnelie MA, Khammari A, Dréno B, Corvec S | title = Cutibacterium acnes molecular typing: time to standardize the method | journal = Clinical Microbiology and Infection | volume = 24 | issue = 11 | pages = 1149–1155 | date = November 2018 | pmid = 29544912 | doi = 10.1016/j.cmi.2018.03.010 | url = https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(18)30216-7/pdf | access-date = 17 August 2018 | doi-access = free }}</ref><ref name="Zeller">{{cite journal | vauthors = Zeller VA, Letembet VA, Meyssonnier VA, Heym B, Ziza JM, Marmor SD | title = Cutibacterium (Formerly Propionibacterium) avidum: A Rare but Avid Agent of Prosthetic Hip Infection | journal = The Journal of Arthroplasty | volume = 33 | issue = 7 | pages = 2246–2250 | date = July 2018 | pmid = 29544969 | doi = 10.1016/j.arth.2018.02.008 | s2cid = 3916758 | url = https://www.arthroplastyjournal.org/article/S0883-5403(18)30135-9/fulltext?rss=yes | access-date = 17 August 2018 | url-access = subscription }}</ref>

==Role in diseases==

=== Acne vulgaris ===
''Cutibacterium acnes'' bacteria predominantly live deep within follicles and [[Sweat pore|pores]], although they are also found on the surface of healthy skin.<ref name="Dréno"/>  In these follicles, ''C. acnes'' bacteria use [[sebum]], cellular debris and metabolic byproducts from the surrounding skin tissue as their primary sources of energy and nutrients.  Elevated production of sebum by hyperactive [[sebaceous gland]]s ([[sebaceous hyperplasia]]) or blockage of the follicle can cause ''C. acnes'' bacteria to grow and multiply.<ref>{{cite journal | vauthors = Zouboulis CC | title = Acne and sebaceous gland function | journal = Clinics in Dermatology | volume = 22 | issue = 5 | pages = 360–6 | year = 2011 | pmid = 15556719 | doi = 10.1016/j.clindermatol.2004.03.004 }}</ref>

''Cutibacterium acnes'' bacteria secrete many proteins, including several digestive enzymes.<ref>{{cite journal | vauthors = Holland C, Mak TN, Zimny-Arndt U, Schmid M, Meyer TF, Jungblut PR, Brüggemann H | title = Proteomic identification of secreted proteins of Propionibacterium acnes | journal = BMC Microbiology | volume = 10 | pages = 230 | date = August 2010 | pmid = 20799957 | pmc = 3224659 | doi = 10.1186/1471-2180-10-230 | doi-access = free }}</ref>  These enzymes are involved in the digestion of sebum and the acquisition of other nutrients.  They can also destabilize the layers of cells that form the walls of the follicle.  The cellular damage, metabolic byproducts and bacterial debris produced by the rapid growth of ''C. acnes'' in follicles can trigger inflammation.<ref>{{cite journal | vauthors = Kim J | title = Review of the innate immune response in acne vulgaris: activation of Toll-like receptor 2 in acne triggers inflammatory cytokine responses | journal = Dermatology | volume = 211 | issue = 3 | pages = 193–8 | year = 2005 | pmid = 16205063 | doi = 10.1159/000087011 | s2cid = 21459334 }}</ref>  This inflammation can lead to the symptoms associated with some common skin disorders, such as [[folliculitis]] and [[acne vulgaris]].<ref>{{cite journal | vauthors = Zouboulis CC | title = Acne and sebaceous gland function | journal = Clinics in Dermatology | volume = 22 | issue = 5 | pages = 360–6 | year = 2004 | pmid = 15556719 | doi = 10.1016/j.clindermatol.2004.03.004 }}</ref><ref>{{cite web|url=http://newsinhealth.nih.gov/2010/January/feature2.htm |title=Understanding Acne - News in Health, January 2010 |publisher=Newsinhealth.nih.gov |access-date=2012-06-14}}</ref> Acne vulgaris is the disease most commonly associated with ''C. acnes'' infection.{{cn|date=February 2023}} Cutibacterium acnes is one of the most common and universal skin diseases, affecting more than 45 million individuals in the United States. 20% of all dermatologist visits are related to treating acne-related issues. This issue often develops during hormonal periods; however, it is also apparent through early adulthood.<ref name="Bhatia2004"/> There are no quantitative differences between C. acnes of the skin of patients with acne, but the C. acnes phylogenetic groups display distinct genetic and phenotypic characteristics. C. acnes [[Biofilm|biofilms]] are also found much more frequently in acne and can induce distinct [[Immune response|immune responses]] to combat against acne. <ref name=":1">{{cite journal |last1=Platsidaki |first1=E |last2=Dessinioti |first2=C |title=Recent advances in understanding Propionibacterium acnes ( Cutibacterium acnes) in acne. |journal=F1000Research |date=2018 |volume=7 |page=1953 |doi=10.12688/f1000research.15659.1 |doi-access=free |pmid=30613388 |pmc=6305227 }}</ref>[[File:Comedo acne 0001.jpg|thumb|Comedo acne from C. acnes]]


Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit, which includes the hair follicle, hair shaft, and sebaceous gland and about 650 million people are affected globally by this disease.<ref>{{Cite journal |last1=Tuchayi |first1=Sara Moradi |last2=Makrantonaki |first2=Evgenia |last3=Ganceviciene |first3=Ruta |last4=Dessinioti |first4=Clio |last5=Feldman |first5=Steven R. |last6=Zouboulis |first6=Christos C. |date=2015-09-17 |title=Acne vulgaris |url=https://www.nature.com/articles/nrdp201529 |journal=Nature Reviews Disease Primers |language=en |volume=1 |issue=1 |page=15029 |doi=10.1038/nrdp.2015.29 |pmid=27189872 |issn=2056-676X|url-access=subscription }}</ref> ''C. acnes'' starts to colonize on the skin around 1 to 3 years prior to puberty and grows exponentially during this time.<ref>{{Cite web |title=Cutibacterium (Propionibacterium) Infections Clinical Presentation: History, Complications |url=https://emedicine.medscape.com/article/226337-clinical |access-date=2022-04-22 |website=emedicine.medscape.com}}</ref> This is why so many teens and young adults struggle with acne. Prescriptions to treat acne are often antibiotics. However, with the rise of [[Antimicrobial resistance|antibiotic resistance]], antibiotics are now often combined with broad-spectrum antibacterial agents such as benzoyl peroxide, and other medications like [[isotretinoin]] (commonly known by the brand name Accutane) are being used on patients with severe or resistant acne.<ref>{{cite journal | pmid=12653738 |title=Antibiotic-resistant acne: lessons from Europe. |year=2003 |last1=Ross|journal=British Journal of Dermatology |volume=148 |issue=3 |pages=467–78 |doi=10.1046/j.1365-2133.2003.05067.x|display-authors=etal|hdl=10454/3069 |arxiv=0706.4406 |s2cid=20838517 }}</ref>

=== ''Staphylococcus'' ''epidermidis'' ===
The damage caused by ''C. acnes'' and the associated inflammation make the affected tissue more susceptible to colonization by [[Opportunistic infection|opportunistic bacteria]], such as ''[[Staphylococcus aureus]]''. Preliminary research shows healthy pores are only colonized by ''C. acnes'', while unhealthy ones universally include the nonpore-resident ''[[Staphylococcus epidermidis]]'', amongst other bacterial contaminants. Whether this is a root causality, just opportunistic and a side effect, or a more complex pathological duality between ''C. acnes'' and this particular ''Staphylococcus'' species is not known.<ref name="Propionibacterium acnes DNA detecte">{{cite journal | vauthors = Hiramatsu J, Kataoka M, Nakata Y, Okazaki K, Tada S, Tanimoto M, Eishi Y | title = Propionibacterium acnes DNA detected in bronchoalveolar lavage cells from patients with sarcoidosis | journal = Sarcoidosis, Vasculitis, and Diffuse Lung Diseases | volume = 20 | issue = 3 | pages = 197–203 | date = October 2003 | pmid = 14620162 }}</ref> Current research has pointed to the idea that ''C. acnes'' and ''S. epidermidis'' have a symbiotic relationship.<ref name=":0">{{cite journal | vauthors = Fournière M, Latire T, Souak D, Feuilloley MG, Bedoux G | title = ''Staphylococcus epidermidis'' and ''Cutibacterium acnes'': Two Major Sentinels of Skin Microbiota and the Influence of Cosmetics | journal = Microorganisms | volume = 8 | issue = 11 | pages = 1752 | date = November 2020 | pmid = 33171837 | pmc = 7695133 | doi = 10.3390/microorganisms8111752 | doi-access = free }}</ref> Both bacteria exist on the normal flora of the skin and a disrupt in balance of these bacteria on the skin can result in acne or other bacterial infection.<ref name=":0" />

In addition to contributing to skin inflammation and acne lesions, an imbalance in these bacteria may also impair the skin's ability to heal and regenerate, leading to prolonged and more severe acne outbreaks. This disruption can also affect the skin's overall microbiome diversity, potentially increasing susceptibility to other skin conditions such as eczema or rosacea. Investigating the dynamics of this relationship may offer insights into novel therapeutic approaches for managing various skin disorders.<ref>{{cite journal |last1=Otto |first1=M |title=Staphylococcus epidermidis--the 'accidental' pathogen |journal=Nat Rev Microbiol |date=7 August 2009 |volume=7 |issue=8 |pages=555–567 |doi=10.1038/nrmicro2182 |pmid=19609257 |pmc=2807625 }}</ref>

=== Ophthalmic complications ===
''Cutibacterium acnes'' is a common cause of chronic [[endophthalmitis]] following [[cataract surgery]]. The pathogen may also cause [[corneal ulcer]]s.<ref>{{Cite journal |last1=Lim |first1=Sung A. |last2=Na |first2=Kyung-Sun |last3=Joo |first3=Choun-Ki |date=September 2017 |title=Clinical Features of Infectious Keratitis Caused by Propionibacterium Acnes |url=https://journals.lww.com/claojournal/Abstract/2017/09000/Clinical_Features_of_Infectious_Keratitis_Caused.10.aspx |journal=Eye & Contact Lens |language=en-US |volume=43 |issue=5 |pages=330–333 |doi=10.1097/ICL.0000000000000281 |pmid=27203796 |s2cid=22829150 |issn=1542-233X|url-access=subscription }}</ref>

=== Disk herniation ===
''Cutibacterium acnes'' has been found in [[herniated disc]]s.<ref>{{cite journal | vauthors = Capoor MN, Ruzicka F, Schmitz JE, James GA, Machackova T, Jancalek R, Smrcka M, Lipina R, Ahmed FS, Alamin TF, Anand N, Baird JC, Bhatia N, Demir-Deviren S, Eastlack RK, Fisher S, Garfin SR, Gogia JS, Gokaslan ZL, Kuo CC, Lee YP, Mavrommatis K, Michu E, Noskova H, Raz A, Sana J, Shamie AN, Stewart PS, Stonemetz JL, Wang JC, Witham TF, Coscia MF, Birkenmaier C, Fischetti VA, Slaby O | display-authors = 6 | title = Propionibacterium acnes biofilm is present in intervertebral discs of patients undergoing microdiscectomy | journal = PLOS ONE | volume = 12 | issue = 4 | pages = e0174518 | date = 2017-04-03 | pmid = 28369127 | pmc = 5378350 | doi = 10.1371/journal.pone.0174518 | bibcode = 2017PLoSO..1274518C | doi-access = free }}</ref> The propionic acid which it secretes creates micro-fractures of the surrounding bone. These micro-fractures are sensitive and it has been found that antibiotics have been helpful in resolving this type of low back pain.<ref>{{cite journal | vauthors = Albert HB, Sorensen JS, Christensen BS, Manniche C | title = Antibiotic treatment in patients with chronic low back pain and vertebral bone edema (Modic type 1 changes): a double-blind randomized clinical controlled trial of efficacy | journal = European Spine Journal | volume = 22 | issue = 4 | pages = 697–707 | date = April 2013 | pmid = 23404353 | pmc = 3631045 | doi = 10.1007/s00586-013-2675-y }}</ref>

=== Sarcoidosis ===
''Cutibacterium acnes'' can be found in [[bronchoalveolar lavage]] of approximately 70% of patients with [[sarcoidosis]] and is associated with disease activity, but it can also be found in 23% of controls.<ref name="Propionibacterium acnes DNA detecte"/><ref>{{cite journal | vauthors = Inoue Y, Suga M | title = [Granulomatous diseases and pathogenic microorganism] | journal = Kekkaku | volume = 83 | issue = 2 | pages = 115–30 | date = February 2008 | pmid = 18326339 }}</ref>  The subspecies of ''C. acnes'' that cause these infections of otherwise sterile tissues (prior to medical procedures), however, are the same subspecies found on the skin of individuals who do not have acne-prone skin, so are likely local contaminants.  Moderate to severe [[acne vulgaris]] appears to be more often associated with virulent strains.<ref>{{cite journal | vauthors = Lomholt HB, Kilian M | title = Population genetic analysis of Propionibacterium acnes identifies a subpopulation and epidemic clones associated with acne | journal = PLOS ONE | volume = 5 | issue = 8 | pages = e12277 | date = August 2010 | pmid = 20808860 | pmc = 2924382 | doi = 10.1371/journal.pone.0012277 | veditors = Bereswill S | bibcode = 2010PLoSO...512277L | doi-access = free }}</ref>

=== Opportunistic diseases ===
''Cutibacterium acnes'' is often considered an [[Opportunistic infection|opportunistic pathogen]], causing a range of postoperative and device-related infections, notably e.g., surgical infections,<ref>Haidar R., Najjar M., Boghossian A.D., Tabbarah Z., "Propionibacterium acnes causing delayed postoperative spine infection: Review." Scandinavian Journal of Infectious Diseases. 42 (6-7) (pp 405-411), 2010</ref> post-neurosurgical infections,<ref>Nisbet, M.;  Briggs, S.; Ellis-Pegler, R.; Thomas, M. ;Holland, D. "Propionibacterium acnes: an under-appreciated cause of post-neurosurgical infection" [[Journal of Antimicrobial Chemotherapy]]. 60(5). NOV 2007. 1097-1103.1103.</ref> infected joint [[prosthesis|prostheses]] (especially shoulder),<ref>{{cite journal | vauthors = Levy PY, Fenollar F, Stein A, Borrione F, Cohen E, Lebail B, Raoult D | title = Propionibacterium acnes postoperative shoulder arthritis: an emerging clinical entity | journal = Clinical Infectious Diseases | volume = 46 | issue = 12 | pages = 1884–6 | date = June 2008 | pmid = 18462110 | doi = 10.1086/588477 | doi-access = free }}</ref> neurosurgical [[Shunt (medical)|shunt]] infections and [[Infective endocarditis|endocarditis]] in patients with [[prosthetic heart valve]]s (predominantly men).<ref>{{cite journal | vauthors = Sohail MR, Gray AL, Baddour LM, Tleyjeh IM, Virk A | title = Infective endocarditis due to Propionibacterium species | journal = Clinical Microbiology and Infection | volume = 15 | issue = 4 | pages = 387–94 | date = April 2009 | pmid = 19260876 | doi = 10.1111/j.1469-0691.2009.02703.x | doi-access = free }}</ref> ''C. acnes'' may play a role in other conditions, including  [[SAPHO syndrome|SAPHO]] (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome, [[sarcoidosis]] and [[sciatica]].<ref>Perry A., Lambert P. " Propionibacterium acnes: Infection beyond the skin." Expert Review of Anti-Infective Therapy. 9 (12) (pp 1149-1156), 2011</ref> It is also suspected a main bacterial source of [[neuroinflammation]] in [[Alzheimer's disease]] brains.<ref>{{cite journal | vauthors = Emery DC, Shoemark DK, Batstone TE, Waterfall CM, Coghill JA, Cerajewska TL, Davies M, West NX, Allen SJ | display-authors = 6 | title = 16S rRNA Next Generation Sequencing Analysis Shows Bacteria in Alzheimer's Post-Mortem Brain | journal = Frontiers in Aging Neuroscience | volume = 9 | pages = 195 | year = 2017 | pmid = 28676754 | pmc = 5476743 | doi = 10.3389/fnagi.2017.00195 | doi-access = free }}</ref> It is a common contaminant in [[blood]] and [[cerebrospinal fluid]] cultures.<ref name="Portillo">{{cite journal | vauthors = Portillo ME, Corvec S, Borens O, Trampuz A | title = Propionibacterium acnes: an underestimated pathogen in implant-associated infections | journal = BioMed Research International | volume = 2013 | pages = 804391 | date = 2013 | pmid = 24308006 | pmc = 3838805 | doi = 10.1155/2013/804391 | doi-access = free }}</ref><ref name="Gharamti">{{cite journal | vauthors = Gharamti AA, Kanafani ZA | title = Cutibacterium (formerly Propionibacterium) acnes infections associated with implantable devices | journal = Expert Review of Anti-Infective Therapy | volume = 15 | issue = 12 | pages = 1083–1094 | date = December 2017 | pmid = 29125405 | doi = 10.1080/14787210.2017.1404452 | s2cid = 205850559 }}</ref>

==Antimicrobial susceptibility==
''Cutibacterium acnes'' bacteria are susceptible to a wide range of antimicrobial molecules, from both pharmaceutical and natural sources. The antibiotics most frequently used to treat acne vulgaris are [[erythromycin]], [[clindamycin]], [[doxycycline]], and [[minocycline]].<ref>{{cite web |url=http://www.skincarephysicians.com/acnenet/prescriptmeds.html |title=Prescription Medications for Treating Acne |publisher=Skincarephysicians.com |date=2007-02-16 |access-date=2012-06-14 |archive-url=https://web.archive.org/web/20120620204503/http://www.skincarephysicians.com/acnenet/prescriptmeds.html |archive-date=2012-06-20 }}</ref><ref>{{Cite web |url=http://jawlineacne.com/ |title=The Cause Of Acne and Natural or Medical Acne Treatment |access-date=2019-11-18 |url-status=usurped |archive-url=https://web.archive.org/web/20171011021816/http://jawlineacne.com/ |archive-date=2017-10-11 }}</ref><ref>{{cite journal | vauthors = Strauss JS, Krowchuk DP, Leyden JJ, Lucky AW, Shalita AR, Siegfried EC, Thiboutot DM, Van Voorhees AS, Beutner KA, Sieck CK, Bhushan R | display-authors = 6 | title = Guidelines of care for acne vulgaris management | journal = Journal of the American Academy of Dermatology | volume = 56 | issue = 4 | pages = 651–63 | date = April 2007 | pmid = 17276540 | doi = 10.1016/j.jaad.2006.08.048 }}</ref>  Several other families of antibiotics are also active against ''C. acnes'' bacteria, including quinolones, cephalosporins, pleuromutilins, penicillins, and sulfonamides.<ref>{{cite journal | vauthors = Hoeffler U, Ko HL, Pulverer G | title = Antimicrobiol susceptibility of Propinibacterium acnes and related microbial species | journal = Antimicrobial Agents and Chemotherapy | volume = 10 | issue = 3 | pages = 387–94 | date = September 1976 | pmid = 984781 | pmc = 429758 | doi = 10.1128/aac.10.3.387 }}</ref><ref>{{cite journal | vauthors = Wang WL, Everett ED, Johnson M, Dean E | title = Susceptibility of Propionibacterium acnes to seventeen antibiotics | journal = Antimicrobial Agents and Chemotherapy | volume = 11 | issue = 1 | pages = 171–3 | date = January 1977 | pmid = 836012 | pmc = 351938 | doi = 10.1128/aac.11.1.171 }}</ref><ref>{{cite web|url=http://scienceofacne.com/antibiotic-susceptibility-of-propionibacterium-acnes/|title=Antibiotic Susceptibility of Propionibacterium acnes|publisher=ScienceOfAcne.com |date=2011-07-15 |access-date=2012-08-08}}</ref>

=== Antibiotic-resistance ===
The emergence of [[Antimicrobial resistance|antibiotic-resistant]] ''C. acnes'' bacteria represents a growing problem worldwide.<ref>{{cite journal | vauthors = Tzellos T, Zampeli V, Makrantonaki E, Zouboulis CC | title = Treating acne with antibiotic-resistant bacterial colonization | journal = Expert Opinion on Pharmacotherapy | volume = 12 | issue = 8 | pages = 1233–47 | date = June 2011 | pmid = 21355786 | doi = 10.1517/14656566.2011.553192 | s2cid = 26957816 }}</ref>  The problem is especially pronounced in North America and Europe.<ref>{{cite journal | vauthors = Ross JI, Snelling AM, Eady EA, Cove JH, Cunliffe WJ, Leyden JJ, Collignon P, Dréno B, Reynaud A, Fluhr J, Oshima S | display-authors = 6 | title = Phenotypic and genotypic characterization of antibiotic-resistant Propionibacterium acnes isolated from acne patients attending dermatology clinics in Europe, the U.S.A., Japan and Australia | journal = The British Journal of Dermatology | volume = 144 | issue = 2 | pages = 339–46 | date = February 2001 | pmid = 11251569 | doi = 10.1046/j.1365-2133.2001.03956.x | arxiv = 1510.02343 | s2cid = 44614220 | hdl = 10454/3311 }}</ref>  The antibiotic families that ''C. acnes'' are most likely to acquire resistance to are the [[macrolide]]s (e.g., erythromycin and [[azithromycin]]), [[lincosamide]]s (e.g., clindamycin) and [[tetracycline]]s (e.g., doxycycline and minocycline).<ref>{{cite journal | vauthors = Ross JI, Snelling AM, Carnegie E, Coates P, Cunliffe WJ, Bettoli V, Tosti G, Katsambas A, Galvan Peréz Del Pulgar JI, Rollman O, Török L, Eady EA, Cove JH | display-authors = 6 | title = Antibiotic-resistant acne: lessons from Europe | journal = The British Journal of Dermatology | volume = 148 | issue = 3 | pages = 467–78 | date = March 2003 | pmid = 12653738 | doi = 10.1046/j.1365-2133.2003.05067.x | s2cid = 20838517 | hdl = 10454/3069 }}</ref><ref>{{cite journal | vauthors = Coates P, Vyakrnam S, Eady EA, Jones CE, Cove JH, Cunliffe WJ | title = Prevalence of antibiotic-resistant propionibacteria on the skin of acne patients: 10-year surveillance data and snapshot distribution study | journal = The British Journal of Dermatology | volume = 146 | issue = 5 | pages = 840–8 | date = May 2002 | pmid = 12000382 | doi = 10.1046/j.1365-2133.2002.04690.x | s2cid = 5725343 }}</ref>

However, ''C. acnes'' bacteria are susceptible to many types of antimicrobial chemicals found in [[over-the-counter]] antibacterial products, including [[benzoyl peroxide]],<ref>{{cite journal | vauthors = Leyden JJ, Wortzman M, Baldwin EK | title = Antibiotic-resistant Propionibacterium acnes suppressed by a benzoyl peroxide cleanser 6% | journal = Cutis | volume = 82 | issue = 6 | pages = 417–21 | date = December 2008 | pmid = 19181031 }}</ref> [[triclosan]],<ref>{{cite web |title=Q&A for Health Care Professionals: Health Care Antiseptics |url=https://www.fda.gov/drugs/information-drug-class/qa-health-care-professionals-health-care-antiseptics |website=U.S. Food and Drug Administration |access-date=17 August 2018|date=December 19, 2017}}</ref> [[chloroxylenol]],<ref name="Emsley">{{cite book | vauthors = Emsley J |title=Vanity, Vitality, and Virility: The Chemistry Behind the Products You Love to Buy |date=July 1, 2004 |publisher=Oxford University |isbn=978-0-19-280509-6 |url=https://archive.org/details/vanityvitalityvi00emsl |url-access=registration |page=[https://archive.org/details/vanityvitalityvi00emsl/page/130 130] |access-date=17 August 2018}}</ref>  and [[chlorhexidine gluconate]].<ref name="Shimizu">{{cite journal | vauthors = Yamakoshi T, Makino T, Matsunaga K, Yoshihisa Y, Rehman MU, Seki T, Hayashi Y, Shimizu T | display-authors = 6 | title = Efficacy of chlorhexidine gluconate ointment (Oronine H(®)) for experimentally-induced comedones | journal = Clinical, Cosmetic and Investigational Dermatology | volume = 5 | pages = 79–83 | date = July 2012 | pmid = 22936850 | pmc = 3426266 | doi = 10.2147/CCID.S33361 | doi-access = free }}</ref>

C. acnes resistance to antibiotics has increased to 64% in 2000, up from 20% in 1979. Treatments such as oral macrolides are often avoided because the bacteria has become resistant in most cases. This creates a public health issue, forcing healthcare providers to seek out other forms of treatment.<ref name=":1" />

==== Treatments ====
Several naturally occurring molecules and compounds are toxic to ''C. acnes'' bacteria.  Some [[essential oil]]s such as rosemary,<ref name="pmid17893831">{{cite journal | vauthors = Fu Y, Zu Y, Chen L, Efferth T, Liang H, Liu Z, Liu W | title = Investigation of antibacterial activity of rosemary essential oil against Propionibacterium acnes with atomic force microscopy | journal = Planta Medica | volume = 73 | issue = 12 | pages = 1275–80 | date = October 2007 | pmid = 17893831 | doi = 10.1055/s-2007-981614 | s2cid = 37769650 }}</ref> [[tea tree oil]],<ref>{{cite journal | vauthors = Raman A, Weir U, Bloomfield SF | title = Antimicrobial effects of tea-tree oil and its major components on Staphylococcus aureus, Staph. epidermidis and Propionibacterium acnes | journal = Letters in Applied Microbiology | volume = 21 | issue = 4 | pages = 242–5 | date = October 1995 | pmid = 7576514 | doi = 10.1111/j.1472-765x.1995.tb01051.x | s2cid = 5687026 }}</ref> [[clove oil]],<ref>{{cite journal | vauthors = Fu Y, Chen L, Zu Y, Liu Z, Liu X, Liu Y, Yao L, Efferth T | display-authors = 6 | title = The antibacterial activity of clove essential oil against Propionibacterium acnes and its mechanism of action | journal = Archives of Dermatology | volume = 145 | issue = 1 | pages = 86–8 | date = January 2009 | pmid = 19153353 | doi = 10.1001/archdermatol.2008.549 | doi-access = free }}</ref> and [[citrus oils]]<ref>{{cite journal | vauthors = Lang G, Buchbauer G | title = A review on recent research results (2008–2010) on essential oils as antimicrobials and antifungals. A review. | journal = Flavour and Fragrance Journal | date = January 2012 | volume = 27 | issue = 1 | pages = 13–39 | doi = 10.1002/ffj.2082 }}</ref><ref name="pmid18239420">{{cite journal | vauthors = Baik JS, Kim SS, Lee JA, Oh TH, Kim JY, Lee NH, Hyun CG | title = Chemical composition and biological activities of essential oils extracted from Korean endemic citrus species | journal = Journal of Microbiology and Biotechnology | volume = 18 | issue = 1 | pages = 74–9 | date = January 2008 | pmid = 18239420 | url = https://www.koreascience.or.kr/article/JAKO200832642389230.page }}</ref> contain antibacterial chemicals. Natural [[honey]] has also been shown to have some antibacterial properties that may be active against ''C. acnes''.<ref>{{cite journal | vauthors = Albietz JM, Lenton LM | title = Effect of antibacterial honey on the ocular flora in tear deficiency and meibomian gland disease | journal = Cornea | volume = 25 | issue = 9 | pages = 1012–9 | date = October 2006 | pmid = 17133045 | doi = 10.1097/01.ico.0000225716.85382.7b | s2cid = 12053077 }}</ref>

The elements [[silver]],<ref>{{cite journal | vauthors = Bayston R, Vera L, Mills A, Ashraf W, Stevenson O, Howdle SM | title = In vitro antimicrobial activity of silver-processed catheters for neurosurgery | journal = The Journal of Antimicrobial Chemotherapy | volume = 65 | issue = 2 | pages = 258–65 | date = February 2010 | pmid = 19942617 | doi = 10.1093/jac/dkp420 | doi-access = free }}</ref> [[sulfur]],<ref>{{cite journal | vauthors = Libenson L, Hadley FP, Mcilroy AP, Wetzel VM, Mellon RR | title = Antibacterial effect of elemental sulfur | journal = The Journal of Infectious Diseases | volume = 93 | issue = 1 | pages = 28–35 | year = 1953 | pmid = 13069766 | doi = 10.1093/infdis/93.1.28 }}</ref> and [[copper]]<ref>{{cite journal | vauthors = McLean RJ, Hussain AA, Sayer M, Vincent PJ, Hughes DJ, Smith TJ | title = Antibacterial activity of multilayer silver-copper surface films on catheter material | journal = Canadian Journal of Microbiology | volume = 39 | issue = 9 | pages = 895–9 | date = September 1993 | pmid = 8242490 | doi = 10.1139/m93-134 }}</ref> have also been demonstrated to be toxic towards many bacteria, including ''C. acnes''.

[[Salicylic acid]] is a naturally occurring substance derived from plants (white willow bark and wintergreen leaves) used to promote exfoliation of the skin in order to treat acne. Additionally, research investigates the [[doi:10.1111/exd.13934|mechanism]] by which salicylic acid (SA) treats acne vulgaris. A study finds that SA suppresses the AMPK/SREBP1 (AMP-activated protein kinase)(AMPK/SREBP1 pathway is a signaling pathway involved in the regulation of lipid metabolism in sebocytes, which are the cells responsible for producing sebum in the skin) pathway in sebocytes, leading to a decrease in lipid synthesis and sebum production. SA also reduces the inflammatory response of sebocytes and decreases the proliferation of ''C.'' ''acnes''. These results suggest that SA has a multifaceted approach in treating acne vulgaris by targeting several key factors that contribute to its development.<ref>{{cite journal | vauthors = Lu J, Cong T, Wen X, Li X, Du D, He G, Jiang X | title = Salicylic acid treats acne vulgaris by suppressing AMPK/SREBP1 pathway in sebocytes | journal = Experimental Dermatology | volume = 28 | issue = 7 | date = October 2019 |pages= 786–794 | doi = 10.1111/exd.13934 | pmid = 30972839 | s2cid = 108295123 }}</ref> The minimum inhibitory concentration for SA is [[doi:10.1038/s41598-019-50746-4|4000–8000 μg/mL]].<ref>{{cite journal | vauthors = Blaskovich MA, Elliott AG, Kavanagh AM, Ramu S, Cooper MA | title = ''In vitro'' Antimicrobial Activity of Acne Drugs Against Skin-Associated Bacteria | journal = Scientific Reports | volume = 9 | date = October 2019 | issue = 1 | page = 14658 | doi = 10.1038/s41598-019-50746-4 | pmid = 31601845 | pmc = 6787063 | bibcode = 2019NatSR...914658B |doi-access=free}}</ref>

==Photosensitivity==
''Cutibacterium acnes'' glows orange when exposed to [[blacklight]], possibly due to the presence of endogenous [[porphyrin]]s. It is also killed by [[ultraviolet|ultraviolet light]]. ''C. acnes'' is especially sensitive to light in the 405–420&nbsp;nanometer (near the ultraviolet) range due to an endogenic porphyrin–coporphyrin III. A total [[radiant exposure]] of 320 J/cm<sup>2</sup> inactivates this species ''in vitro''.<ref name="british">{{cite journal | vauthors = Papageorgiou P, Katsambas A, Chu A | title = Phototherapy with blue (415 nm) and red (660 nm) light in the treatment of acne vulgaris | journal = The British Journal of Dermatology | volume = 142 | issue = 5 | pages = 973–8 | date = May 2000 | pmid = 10809858 | doi = 10.1046/j.1365-2133.2000.03481.x | s2cid = 9237317 }}</ref> Its photosensitivity can be enhanced by pretreatment with [[aminolevulinic acid]], which boosts production of this chemical, although this causes significant side effects in humans, and in practice was not significantly better than the light treatment alone.<ref name="Togsverd-Bo">{{cite journal | vauthors = Togsverd-Bo K, Wiegell SR, Wulf HC, Haedersdal M | title = Short and limited effect of long-pulsed dye laser alone and in combination with photodynamic therapy for inflammatory rosacea | journal = Journal of the European Academy of Dermatology and Venereology | volume = 23 | issue = 2 | pages = 200–1 | date = February 2009 | pmid = 18452529 | doi = 10.1111/j.1468-3083.2008.02781.x | s2cid = 30935383 }}</ref><ref name="Lin">{{cite journal | vauthors = Wan MT, Lin JY | title = Current evidence and applications of photodynamic therapy in dermatology | journal = Clinical, Cosmetic and Investigational Dermatology | volume = 7 | pages = 145–63 | date = May 2014 | pmid = 24899818 | pmc = 4038525 | doi = 10.2147/CCID.S35334 | doi-access = free }}</ref>

==Other habitats==
''Cutibacterium acnes'' has been found to be an [[endophyte]] of plants. Notably, [[grapevine]] appears to host an endophytic population of ''C. acnes'' that is closely related to the human-associated strains. The two lines diverged roughly 7,000 years ago, at about the same time when [[grapevine]] agriculture may have been established.  This [[Propionibacterium acnes type zappae|''C. acnes'' subtype]] was dubbed ''Zappae'' in honour of the eccentric composer [[Frank Zappa]], to highlight its unexpected and unconventional habitat.<ref name="zappa">{{cite journal | vauthors = Campisano A, Ometto L, Compant S, Pancher M, Antonielli L, Yousaf S, Varotto C, Anfora G, Pertot I, Sessitsch A, Rota-Stabelli O | display-authors = 6 | title = Interkingdom transfer of the acne-causing agent, Propionibacterium acnes, from human to grapevine | journal = Molecular Biology and Evolution | volume = 31 | issue = 5 | pages = 1059–65 | date = May 2014 | pmid = 24554779 | doi = 10.1093/molbev/msu075 | doi-access = free }}</ref>

==References==
{{Reflist}}

==External links==
* {{Commons category-inline}}
* {{MeshName|Propionibacterium+acnes}}
* [http://microbewiki.kenyon.edu/index.php/Propionibacterium Propionibacterium] (Kenyon College)
* [http://bacdive.dsmz.de/index.php?search=12636&submit=Search Type strain of ''Propionibacterium acnes'' at Bac''Dive'' - the Bacterial Diversity Metadatabase]

{{Gram-positive actinobacteria diseases}}
{{Taxonbar|from=Q2442109}}
{{Authority control}}

[[Category:Propionibacteriales]]
[[Category:Gram-positive bacteria]]
[[Category:Bacteria described in 1946]]
[[Category:Pathogenic bacteria]]