title: Surveillance of antimicrobial resistance in Lebanese hospitals: retrospective nationwide compiled data.
abstract: Antimicrobial resistance is closely linked to antimicrobial use and is a growing concern worldwide. Antimicrobial resistance increases healthcare costs substantially in many countries, including Lebanon. National data from Lebanon have, in the most part, been limited to a few academic hospitals. The Lebanese Society of Infectious Diseases conducted a retrospective study to better describe the antimicrobial susceptibility patterns of bacterial isolates in Lebanon. Data were based on records retrieved from the bacteriology laboratories of 16 different Lebanese hospitals between January 2011 and December 2013. The susceptibility results of a total 20684 Gram-positive and 55594 Gram-negative bacteria were analyzed. The prevalence rate of methicillin-resistant Staphylococcus aureus was 27.6% and of vancomycin-resistant Enterococcus spp was 1%. Streptococcus pneumoniae had susceptibilities of 46% to oxacillin, 63% to erythromycin, and 98% to levofloxacin. Streptococcus pyogenes had susceptibilities of 94% to erythromycin and 95% to clindamycin. The mean ampicillin susceptibility of Haemophilus influenzae, Salmonella spp, and Shigella spp isolates was 79%, 81.3%, and 62.2%, respectively. The extended-spectrum beta-lactamase production rate for Escherichia coli was 32.3% and for Klebsiella spp was 29.2%. Acinetobacter spp showed high resistance to most antimicrobials, with low resistance to colistin (17.1%). Pseudomonas spp susceptibilities to piperacillin-tazobactam and imipenem were lower than 80% (79.7% and 72.8%, respectively). This study provides population-specific data that are valuable in guiding antimicrobial use in Lebanon and neighbouring countries and will help in the establishment of a surveillance system for antimicrobial resistance following the implementation of a nationwide standardization of laboratory methods and data entry.
authors.affiliation: Department of Internal Medicine, Lebanese American University Medical Center - Rizk Hospital, Beirut, Lebanon.
authors.forename: Kamal
authors.initials: K
authors.lastname: Chamoun
authors.affiliation: Department of Internal Medicine, Lebanese American University Medical Center - Rizk Hospital, Beirut, Lebanon.
authors.forename: Maya
authors.initials: M
authors.lastname: Farah
authors.affiliation: Department of Microbiology, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Georges
authors.initials: G
authors.lastname: Araj
authors.affiliation: Department of Microbiology, Faculty of Medicine, University of Balamand and Centre Hospitalier du nord Hospital, Beirut, Lebanon.
authors.forename: Ziad
authors.initials: Z
authors.lastname: Daoud
authors.affiliation: Department of Infectious Diseases, Makassed Hospital, Beirut, Lebanon.
authors.forename: Rima
authors.initials: R
authors.lastname: Moghnieh
authors.affiliation: School of Pharmacy, Pharmacy Practice Department, Lebanese American University, Byblos, Lebanon.
authors.forename: Pascale
authors.initials: P
authors.lastname: Salameh
authors.affiliation: Epidemiological Surveillance Unit, Ministry of Public Health, Beirut, Lebanon.
authors.forename: Danielle
authors.initials: D
authors.lastname: Saade
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, Lebanese American University - Rizk Hospital, Beirut, Lebanon.
authors.forename: Jacques
authors.initials: J
authors.lastname: Mokhbat
authors.affiliation: Department of Microbiology, Mount Lebanon Hospital, Beirut, Lebanon.
authors.forename: Emme
authors.initials: E
authors.lastname: Abboud
authors.affiliation: Department of Microbiology, NINI Hospital, Tripoli, Lebanon.
authors.forename: Monzer
authors.initials: M
authors.lastname: Hamze
authors.affiliation: Department of Microbiology, Middle East Institute of Health, Mount Lebanon, Lebanon.
authors.forename: Edmond
authors.initials: E
authors.lastname: Abboud
authors.affiliation: Department of Microbiology, Makassed Hospital, Beirut, Lebanon.
authors.forename: Tamima
authors.initials: T
authors.lastname: Jisr
authors.affiliation: Department of Microbiology, Sacré Coeur Hospital, Mount Lebanon, Lebanon.
authors.forename: Antoine
authors.initials: A
authors.lastname: Haddad
authors.affiliation: Department of Microbiology, Rafik Hariri University Hospital, Beirut, Lebanon.
authors.forename: Rita
authors.initials: R
authors.lastname: Feghali
authors.affiliation: Department of Microbiology, Hotel Dieu de France Hospital, Beirut, Lebanon.
authors.forename: Nadim
authors.initials: N
authors.lastname: Azar
authors.affiliation: Department of Microbiology, Hammoud Hospital, Saida, Lebanon.
authors.forename: Mohammad
authors.initials: M
authors.lastname: El-Zaatari
authors.affiliation: Department of Microbiology, Mazloum Hospital, Tripoli, Lebanon.
authors.forename: Marwan
authors.initials: M
authors.lastname: Chedid
authors.affiliation: Department of Microbiology, Notre Dame des Secours Hospital, Byblos, Lebanon.
authors.forename: Christian
authors.initials: C
authors.lastname: Haddad
authors.affiliation: Department of Microbiology, Abou Jaoude Hospital, Mount Lebanon, Lebanon.
authors.forename: Mireille
authors.initials: M
authors.lastname: Zouain Dib Nehme
authors.affiliation: Department of Microbiology, Bellevue Hospital, Mount Lebanon, Lebanon.
authors.forename: Angelique
authors.initials: A
authors.lastname: Barakat
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, Lebanese American University - Rizk Hospital, Beirut, Lebanon. Electronic address: roula.samaha@umcrh.com.
authors.forename: Rola
authors.initials: R
authors.lastname: Husni
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001419:Bacteria / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007861:Lebanon / Q000453:epidemiology; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents
keywords: Gram-negative bacteria; Gram-positive bacteria; Lebanon; Resistance; Susceptibility