Propionibacterium acnes, an emerging pathogen: from acne to implant-infections, from phylotype to resistance

Med Mal Infect. 2014 Jun;44(6):241-50. doi: 10.1016/j.medmal.2014.02.004. Epub 2014 Mar 20.


Propionibacterium acnes colonizes the lipid-rich sebaceous glands of the skin. This preferential anaerobic bacterium is easily identified if cultures are prolonged. It is involved in the inflammation process of acne, but until recently, it was neglected in other clinical presentations. Despite a reported low virulence, the new genomic, transcriptomic, and phylogenetic studies have allowed better understanding of this pathogen's importance that causes many chronic and recurrent infections, including orthopedic and cardiac prosthetic, and breast or eye implant-infections. These infections, facilitated by the ability of P. acnes to produce a biofilm, require using anti-biofilm active antibiotics such as rifampicin. The antibiogram of P. acnes is not systematically performed in microbiology laboratories because of its susceptibility to a wide range of antibiotics. However, in the last 10 years, the rate of antibiotic-resistant bacteria has increased, especially for macrolides and tetracyclines. Recently, rpoB gene mutations conferring resistance to rifampicin have been also reported. Thus in case of a biofilm growth mode, the therapeutic strategy should be discussed, according to the resistance phylotype and phenotype so as to optimize the treatment of these severe infections.

Keywords: Acne; Acné; Antibiotic resistance; Phylotype; Prosthesis or device-related infections; Prothèse; Résistance aux antibiotiques.

Publication types

  • Review

MeSH terms

  • Acne Vulgaris / microbiology
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Proteins / physiology
  • Bacterial Typing Techniques
  • Biofilms
  • Breast Implants / adverse effects
  • Breast Implants / microbiology
  • Cerebrospinal Fluid Shunts / adverse effects
  • Communicable Diseases, Emerging*
  • DNA, Bacterial / genetics
  • Drug Resistance, Multiple, Bacterial / genetics
  • Endophthalmitis / etiology
  • Endophthalmitis / microbiology
  • Eye Infections, Bacterial / etiology
  • Eye Infections, Bacterial / microbiology
  • Genome, Bacterial
  • Gram-Positive Bacterial Infections / drug therapy
  • Gram-Positive Bacterial Infections / epidemiology
  • Gram-Positive Bacterial Infections / microbiology*
  • Gram-Positive Bacterial Infections / transmission
  • Host-Pathogen Interactions
  • Humans
  • Lenses, Intraocular / adverse effects
  • Lenses, Intraocular / microbiology
  • Microbial Sensitivity Tests / methods
  • Phylogeny
  • Propionibacterium acnes / classification
  • Propionibacterium acnes / drug effects
  • Propionibacterium acnes / genetics
  • Propionibacterium acnes / isolation & purification
  • Propionibacterium acnes / pathogenicity*
  • Prosthesis-Related Infections / epidemiology
  • Prosthesis-Related Infections / microbiology
  • Virulence / genetics


  • Anti-Bacterial Agents
  • Bacterial Proteins
  • DNA, Bacterial