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Comparative Study
. 2019 Feb 20:8:41.
doi: 10.1186/s13756-019-0487-5. eCollection 2019.

A compilation of antimicrobial susceptibility data from a network of 13 Lebanese hospitals reflecting the national situation during 2015-2016

Rima Moghnieh #  1   2 , Georges F Araj #  3 , Lyn Awad  4 , Ziad Daoud  5   6 , Jacques E Mokhbat  7   8 , Tamima Jisr  9 , Dania Abdallah  4 , Nadim Azar  10 , Noha Irani-Hakimeh  6   11 , Maher M Balkis  12   13 , Mona Youssef  14 , Gilbert Karayakoupoglou  15 , Monzer Hamze  16 , Madonna Matar  17   18 , Roula Atoui  2   19 , Edmond Abboud  20 , Rita Feghali  21 , Nadine Yared  22 , Rola Husni  7   8
Affiliations
Comparative Study

A compilation of antimicrobial susceptibility data from a network of 13 Lebanese hospitals reflecting the national situation during 2015-2016

Rima Moghnieh et al. Antimicrob Resist Infect Control. .

Abstract

Background: There is a lack of official national antimicrobial resistance (AMR) data in Lebanon. Individual hospitals generate their own antibiotic susceptibility data in the form of yearly pamphlets.

Methods: In this study, antibiotic susceptibility data from 13 hospitals distributed across different governorates of Lebanon were collected to conduct a compilation-based surveillance of AMR in Lebanon for the years 2015-2016. The findings were compared with those of a previous nationwide study in this country conducted between 2011 and 2013 as well as with similar data obtained from the 2015 and 2016 European surveillance reports of AMR. To provide a clear presentation of the AMR situation, mean percent susceptibility of different antibiotic-microbe combinations was calculated.

Results: During 2015-2016, the percent susceptibility of Enterobacteriaceae to third-generation cephalosporins and to carbapenems was 59 and 97%, respectively. Among Pseudomonas aeruginosa and Acinetobacter spp., carbapenem susceptibility reached 70 and 12%, respectively. Among Gram positive organisms, the percent susceptibility to methicillin in Staphylococcus aureus was 72%, that to vancomycin in Enterococcus spp. was 98% and that to penicillin in Streptococcus pneumoniae was 75%. Compared with results of 2011-2013, there was an overall trend of decreased susceptibility of bacteria to the tested antibiotics, with a variation of 5 to 10%. The antibiotic susceptibility data from Lebanon were found to be comparable with those from Eastern and South-eastern European countries.

Conclusion: This study highlights the need to establish a robust national AMR surveillance system that enables data from Lebanon to be included in global AMR maps.

Keywords: Antimicrobial susceptibility; Antimicrobial susceptibility testing; Lebanon; Resistance; Surveillance.

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Conflict of interest statement

This study is based on institutional antimicrobial susceptibility testing (AST) yearly reports/pamphlets generated and distributed by clinical microbiology laboratories. This information is publically available. The institutional review board (IRB) Committee of one of the participating hospitals, Makassed General Hospital, Beirut, Lebanon, granted this study ethical approval. All data were purely based on microorganisms, and no patient data were included; hence, the IRB waived the requirement of informed consent from patients.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow diagram outlining the selection process for Lebanese hospital laboratories whose antibiotic susceptibility data was included in this study
Fig. 2
Fig. 2
Distribution of the total clinical isolates in 2015 and 2016 (%) among the governorates of Lebanon (N = 85,144 isolates)
Fig. 3
Fig. 3
Percentage of resistance among six clinically important bacteria in Lebanon during 2011–2013 and 2015–2016, described by the World Health Organization as priority organisms for research and development of new antimicrobials. KEY: CAR carbapenem, FQ fluoroquinolone, MET methicillin, 3GC third-generation cephalosporins, R resistant. N.B. P < 0.05 is considered statistically significant
Fig. 4
Fig. 4
E. coli percent susceptibility to third-generation cephalosporins (a) and to carbapenems (b) in Lebanon in 2015 and 2016 in comparison with similar data from countries of the European Union, based on the 2015 and 2016 annual reports of the European Antimicrobial Resistance Surveillance Network (EARS-Net)
Fig. 5
Fig. 5
K. pneumoniae percent susceptibility to third-generation cephalosporins (a) and to carbapenems (b) in Lebanon in 2015 and 2016 in comparison with similar data from countries of the European Union, based on the 2015 and 2016 annual reports of the European Antimicrobial Resistance Surveillance Network (EARS-Net)
Fig. 6
Fig. 6
P. aeruginosa (a) and Acinetobacter spp. (b) percent susceptibility to carbapenems in Lebanon in 2015 and 2016 in comparison with similar data from countries of the European Union, based on the 2015 and 2016 annual reports of the European Antimicrobial Resistance Surveillance Network (EARS-Net)
Fig. 7
Fig. 7
S. aureus percent susceptibility to methicillin (a) and S. pneumonaie percent susceptibility to penicillin (b) in Lebanon in comparison with countries of the European Union during 2015 and 2016, based on the 2015 and 2016 annual reports of the European Antimicrobial Resistance Surveillance Network (EARS-Net)
See this image and copyright information in PMC

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