Antimicrobial resistance in Libya: 1970–2011

Abstract

Resistance to antimicrobial agents is a major health problem that affects the whole world. Providing information on the past state of antimicrobial resistance in Libya may assist the health authorities in addressing the problem more effectively in the future. Information was obtained mainly from Highwire Press (including PubMed) search for the period 1970–2011 using the terms ‘antibiotic resistance in Libya’, ‘antimicrobial resistance in Libya’, ‘tuberculosis in Libya’, and ‘primary and acquired resistance in Libya’ in title and abstract. From 1970 to 2011 little data was available on antimicrobial resistance in Libya due to lack of surveillance and few published studies. Available data shows high resistance rates for Salmonella species in the late 1970s and has remained high to the present day. High prevalence rates (54–68%) of methicillin-resistant Staphylococcus aureus (MRSA) were reported in the last decade among S. aureus from patients with burns and surgical wound infections. No reports were found of vancomycin-resistant S. aureus (VRSA) or vancomycin-intermediate-resistant S. aureus (VISA) using standard methods from Libya up to the end of 2011. Reported rates of primary (i.e. new cases) and acquired (i.e. retreatment cases) multidrug-resistant tuberculosis (MDR-TB) from the eastern region of Libya in 1971 were 16.6 and 33.3% and in 1976 were 8.6 and 14.7%, in western regions in 1984–1986 were 11 and 21.5% and in the whole country in 2011 were estimated at 3.4 and 29%, respectively. The problem of antibiotic resistance is very serious in Libya. The health authorities in particular and society in general should address this problem urgently. Establishing monitoring systems based on the routine testing of antimicrobial sensitivity and education of healthcare workers, pharmacists, and the community on the health risks associated with the problem and benefits of prudent use of antimicrobials are some steps that can be taken to tackle the problem in the future.

Carbapenemases and extended-spectrum β-lactamases producing Enterobacteriaceae isolated from Tunisian and Libyan hospitals

“…ESBL-and carbapenemaseproducing Enterobacteriaceae strains are being increasingly reported in Europe, South America, Asia, Oceania, and Africa [8]. The situation is still worse in low-income countries, where there is a lack of antimicrobial-resistance surveys and an absence of adequate policies on antibiotics use [9,10]. The poor state of health has undoubtedly exacerbated the problem of antimicrobial resistance in these countries [10].…”

“…The situation is still worse in low-income countries, where there is a lack of antimicrobial-resistance surveys and an absence of adequate policies on antibiotics use [9,10]. The poor state of health has undoubtedly exacerbated the problem of antimicrobial resistance in these countries [10]. In Tunisia and Libya, misuse of antimicrobial agents by the public is widespread.…”

“…Indeed, in both countries, antimicrobials can be purchased from pharmacies without a prescription, which has led to the rapid emergence of many resistant bacteria. In addition, there is a lack of infection prevention policies and simple control measures, such as hand hygiene, to avoid the spread of pathogens in the hospital setting [9,10].…”

Early initiation of antiretroviral treatment: Challenges in the Middle East and North Africa

“…Estimates show that 56% these MDR-TB patients have been successfully treated in the Eastern Mediterranean Region, and despite better outcomes compared to other regions, this number is much lower than WHO's defined goal of 75% for 2015 [37] . Country-specific studies highlight the urgent need for addressing MDR-TB, specifically among patients who are re-treated with anti-TB drugs [38][39][40] . The situation is becoming especially critical in Saudi Arabia due to high influence of travelers and migrating laborers from TB endemic areas, and also in Somalia which reports the highest prevalence of MDR-TB in the region [41,42] .…”

Etiology of Infection, Femoral Nerve and Splenic Injury by Abdominal Retractor

“…Ampicillin resistance reached 78% and amikacin resistance 2%. 7 Hendricks emphasized that the lack of prophylaxis increased morbidity and mortality in surgical patients as well as the cost of care. 8 The World Health Organization, based on research on the resistance of Gram-positive and Gram-negative bacteria to antibiotics, implemented programs to improve aseptic and antiseptic techniques in order to reduce their use.…”