What is the pathophysiology of Cutibacterium (Propionibacterium) infections?

Updated: Dec 03, 2019
  • Author: Sajeev Handa, MBBCh, BAO, LRCSI, LRCPI; Chief Editor: John L Brusch, MD, FACP  more...
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The three main bacterial genera that reside on the skin’s surface include corynebacteria, cutibacteria, and staphylococci. Interplay of these members is essential for the maintenance of healthy normal skin. While C acnes (predominant in sebaceous sites) is critical in the regulation of skin homeostasis and prevents colonization from harmful pathogens, it may act as an opportunistic pathogen in acne vulgaris. Proliferation of C acnes was once believed to trigger acne, but recent research has instead suggested that a tight equilibrium between members of the skin flora and among C acnes phylotypes may play a role in acne onset. In addition, loss of microbial diversity may lead to chronic inflammation. [3]

C acnes acts as an opportunistic pathogen, causing invasive and chronic implant infections via biofilm growth. A biofilm is defined as a sessile community of microbial cells that are attached to a substratum, an interface, or each other and embedded in a matrix of extracellular polymeric substances. It exhibits an altered phenotype in terms of growth, gene expression, and protein production compared with planktonic bacterial cells. Although C acnes is known to form biofilm on different biomaterials, detailed mechanisms and steps in biofilm formation remain to be fully elucidated. [6]

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