Resistance of Gram-Negative Bacilli in Lebanon

Abstract

Several studies have reported the isolation of resistant Gram-Negative Bacilli in Lebanon. However, those studies are new and scarce as compared to worldwide data and mostly restricted to single center studies. In this review, we attempt to provide a reliable and comprehensive report describing the current situation and providing prospects for bacterial resistance in Lebanon. Several studies have shown that Extended Spectrum -Lactamase-producing E. coli and K. pneumoniae strains are being increasingly reported. Moreover, 2.15% of E. coli and 7.84% of K. pneumoniae isolates have shown carbapenem resistance and up to 30% of isolated E. coli strains were found to be Multi-Drug Resistant. Molecular studies showed that the most widespread -Lactamases in Lebanon are of the CTX-M-15 and SHV types. In addition, K. pneumoniae strains producing metallo--Lactamase and Klebsiella pneumoniae Carbapenemase have been reported. Resistant Pseudomonas aeruginosa and Acinetobacter baumannii caused several nosocomial infections and some Acinetobacter baumannii strains were found to produce OXA-58 type ESBL. e few data addressing the rate of antibiotic consumption in Lebanon show a high rate of antibiotic misuse and abuse. In conclusion, there is a need for antibiotic stewardship programs and additional studies that go beyond the scope of single-center studies in Lebanon.

Antimicrobial Resistance, Virulence Factors, and Pathotypes of Escherichia coli Isolated from Drinking Water Sources in Jordan

“…This could be attributed to the production of low carbapenemase levels, or a false positive MHT mostly generated by ESBL production in association with decreased drug permeability [28]. For comparison, in Lebanon the reported prevalence rate of carbapenemase production was 2.2% among clinical E. coli isolates [29]. MDR E. coli harboring ESBLs and carbapenemases in water sources is alarming, especially considering that carbapenems are usually the antimicrobials of last resort to treat ESBL-producing pathogens.…”

Antimicrobial Susceptibilities and Laboratory Profiles of Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis Isolates as Agents of Urinary Tract Infection in Lebanon: Paving the Way for Better Diagnostics

“…Nevertheless, antimicrobial resistance has been increasing across many settings [ 12 , 13 ], which is attributed in large part to antibiotic misuse. Multidrug resistant (MDR) organism, by definition, is a germ that is resistant to more than three classes of antibiotics [ 14 ]. A review of literature shows that there is an increase in extended spectrum beta-lactamase (ESBL)-producing MDR organisms among both CAUTIs and HAUTIs, threatening the public health sector as a whole [ 15 ].…”

Epidemiology and resistance profiles of Enterobacterales in a tertiary care hospital in Lebanon: a 4-year retrospective study

“…However, our data showed a progressively increasing pattern of ESBL in E. coli. Moreover, multiple studies were conducted in Lebanon regarding ESBL enzymes [22,23], identifying CTX-M enzymes as the most common type. An epidemiological issue regarding these enzymes is that they are mainly found in healthy E. coli colonized subjects, thus forming a community reservoir and leading to increased community and hospital acquired ESBL infections [3].…”