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<p>Antimicrobial resistance in <i>Cutibacterium acnes</i> is a growing concern, limiting treatment options for acne vulgaris (AV) and increasing the risk of opportunistic infections. Photodynamic therapy (PDT), using an effective photosensitizer (PS) and optimized light parameters, is a potent broad-spectrum antimicrobial strategy with minimal risk of resistance development. This study aimed to assess the efficacy of PDT using sodium iron chlorophyllin (CHL-Fe) as an in-house photosensitizer (CH-PDT) against 10 clinically isolated, drug-resistant <i>C. acnes</i> strains. The isolates, obtained from patients with mild to severe AV in a dermatology referral center, were resistant to one or more commonly prescribed antibiotics. CH-PDT was conducted using varying concentrations of CHL-Fe and red light (RL) fluences in laboratory conditions. A consistent bactericidal activity (&gt; 3 log<sub>10</sub> CFU/mL reduction) was achieved across all resistance profiles with a fixed dose of CHL-Fe at 7.5&#xa0;mg/dL combined with RL at 3.5&#xa0;J/cm². Neither CHL-Fe nor RL alone, even at higher doses, produced similar results. The study included pan-, extensively, multi-, and single-drug-resistant strains, making the findings broadly applicable to clinical practice. These findings underscore CH-PDT as a promising nonantibiotic therapy for drug-resistant AV, with potential implications for eradicating <i>C. acnes</i> colonization and preventing infections in surgical and implant-related settings.</p>

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Antimicrobial photodynamic therapy using sodium iron chlorophyllin against drug-resistant Cutibacterium acnes from patients with acne vulgaris

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月13日

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  • Buraya Mahajindawong,
  • Chanat Kumtornrut,
  • Pravit Asawanonda,
  • Stephen J. Kerr,
  • Tanittha Chatsuwan,
  • Einapak Boontaveeyuwat

摘要

Antimicrobial resistance in Cutibacterium acnes is a growing concern, limiting treatment options for acne vulgaris (AV) and increasing the risk of opportunistic infections. Photodynamic therapy (PDT), using an effective photosensitizer (PS) and optimized light parameters, is a potent broad-spectrum antimicrobial strategy with minimal risk of resistance development. This study aimed to assess the efficacy of PDT using sodium iron chlorophyllin (CHL-Fe) as an in-house photosensitizer (CH-PDT) against 10 clinically isolated, drug-resistant C. acnes strains. The isolates, obtained from patients with mild to severe AV in a dermatology referral center, were resistant to one or more commonly prescribed antibiotics. CH-PDT was conducted using varying concentrations of CHL-Fe and red light (RL) fluences in laboratory conditions. A consistent bactericidal activity (> 3 log10 CFU/mL reduction) was achieved across all resistance profiles with a fixed dose of CHL-Fe at 7.5 mg/dL combined with RL at 3.5 J/cm². Neither CHL-Fe nor RL alone, even at higher doses, produced similar results. The study included pan-, extensively, multi-, and single-drug-resistant strains, making the findings broadly applicable to clinical practice. These findings underscore CH-PDT as a promising nonantibiotic therapy for drug-resistant AV, with potential implications for eradicating C. acnes colonization and preventing infections in surgical and implant-related settings.