Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Infection Control and Prevention Program, American University of Beirut Medical Center, Beirut, Lebanon.
J Infect Public Health. 2021 Jan;14(1):12-16. doi: 10.1016/j.jiph.2020.11.006. Epub 2020 Dec 17.
Infections due to antibiotic resistant organisms (ARO) among hospitalized patients are associated with increased morbidity, mortality, and healthcare costs. Longitudinal data about antimicrobial resistance are scarce in Lebanon and the region. The objective of this study is to describe the temporal trends of resistance of selected pathogens among hospitalized patients at a tertiary care center in Lebanon.
We conducted a retrospective review of surveillance data from 2010 until 2018. Six target organisms isolated from hospitalized patients were included: carbapenem-resistant Escherichia coli (CREC), carbapenem-resistant Klebsiella spp. (CRKP), multi-drug resistant Pseudomonas aeruginosa (MDRPA), carbapenem-resistant Acinetobacter baumannii (CRAB), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococcus spp. (VRE). Correlation analysis was performed to evaluate for temporal trends.
A total of 15,901 isolates were examined, most of which were obtained from urinary specimens. Among Gram-negative organisms, the highest resistance was found among CRAB (81.7%), followed by CRKP (6.5%) and CREC (3.3%). MDRPA overall prevalence was 0.8%. Among Gram-positive organisms, the prevalence of MRSA and VRE was 26.2% and 2.6%, respectively. CREC, MRSA, and VRE showed statistically significant increasing temporal trends, while CRAB decreased significantly from 2013 to 2018.
These data are helpful in characterizing the epidemiology of antimicrobial resistance in Lebanon and show that controlling emerging resistance is achievable with concerted infection control and antimicrobial stewardship efforts. Caution should be exercised to contain early on the spread of CREC and of resistant Gram-positive pathogens.
住院患者中抗生素耐药菌（ARO）感染与发病率、死亡率和医疗保健成本增加有关。黎巴嫩和该地区缺乏关于抗菌药物耐药性的纵向数据。本研究的目的是描述黎巴嫩一家三级保健中心住院患者中选定病原体耐药性的时间趋势。
我们对 2010 年至 2018 年的监测数据进行了回顾性分析。纳入了从住院患者中分离的 6 种目标病原体：耐碳青霉烯类大肠埃希菌（CREC）、耐碳青霉烯类肺炎克雷伯菌（CRKP）、多重耐药铜绿假单胞菌（MDRPA）、耐碳青霉烯类鲍曼不动杆菌（CRAB）、耐甲氧西林金黄色葡萄球菌（MRSA）和万古霉素耐药肠球菌（VRE）。进行了相关分析以评估时间趋势。
共检查了 15901 株分离物，其中大部分来自尿液标本。在革兰氏阴性菌中，CRAB 的耐药率最高（81.7%），其次是 CRKP（6.5%）和 CREC（3.3%）。MDRPA 的总体患病率为 0.8%。在革兰氏阳性菌中，MRSA 和 VRE 的患病率分别为 26.2%和 2.6%。CREC、MRSA 和 VRE 呈统计学显著增加的时间趋势，而 CRAB 自 2013 年至 2018 年显著下降。
这些数据有助于了解黎巴嫩抗菌药物耐药性的流行病学特征，并表明通过协调的感染控制和抗菌药物管理努力可以控制新出现的耐药性。应谨慎控制 CREC 和耐药革兰氏阳性病原体的早期传播。
