title: Penicillin-resistant Streptococcus pneumoniae in Lebanon: the first nationwide study.
abstract: A total of 123 clinical isolates of Streptococcus pneumoniae were collected from all over Lebanon and tested for their susceptibility to penicillin: 30.1% were susceptible (minimum inhibitory concentration (MIC) < or = 0.06 microg/mL), 56.1% were intermediately susceptible (MIC 0.09-1.0 microg/mL) and 13.8% were resistant (MIC > 1.0 microg/mL). The oxacillin disk screening test detected all penicillin-resistant isolates, but erroneously designated two penicillin-intermediate isolates as penicillin susceptible. All isolates were consistently susceptible to levofloxacin, but cross-resistance between penicillin and the three tested cephalosporins was frequently noted. The in vitro activity of amoxicillin/clavulanic acid paralleled that of penicillin; however, 92.7% of the isolates were designated as susceptible based on the recommended interpretive cut-off point (MIC < or = 2/1 microg/mL). This discrepancy represents a paradox that deserves serious consideration.
authors.affiliation: American University of Beirut Medical Center, P.O. Box 11 - 0236, Riad El Solh 110 72020, Beirut, Lebanon. mardah@cyberia.net.lb
authors.forename: Marwan
authors.initials: M
authors.lastname: Uwaydah
authors.forename: Jacques E
authors.initials: JE
authors.lastname: Mokhbat
authors.forename: Dolla
authors.initials: D
authors.lastname: Karam-Sarkis
authors.forename: Rita
authors.initials: R
authors.lastname: Baroud-Nassif
authors.forename: Thomas
authors.initials: T
authors.lastname: Rohban
mesh_terms: D007861:Lebanon; D008826:Microbial Sensitivity Tests; D010403:Penicillin Resistance; D010406:Penicillins / Q000494:pharmacology; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000187:drug effects*
chemical_list: D010406:Penicillins