Department of Laboratory and Transfusion Medicine, Lebanese University, Faculty of Medical Sciences, Beirut, Lebanon.
Laboratory Department, Lebanese Hospital Geitaoui University Medical Center, Beirut, Lebanon.
J Infect Dev Ctries. 2023 Jul 27;17(7):986-993. doi: 10.3855/jidc.17313.
Antimicrobial resistance (AMR) is a worldwide problem that threatens treatment effectiveness against the most serious bacterial infections. AMR in Enterobacterales is highly prevalent in Lebanon. However, recent reports regarding the distribution of Enterobacterales and related antimicrobial susceptibility are scarce.
In this retrospective study at the Lebanese Hospital Geitaoui Medical Center in Lebanon, all data regarding culture specimens from urine, blood, sputum, deep tracheal aspirate, broncho-alveolar lavage, wounds, surgical sites, tissue, body fluids, and central venous catheter that were positive for at least one of the 4 bacterial isolates (Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae and Proteus mirabilis) were collected. All susceptibility testing was performed according to the Clinical and Laboratory Standards Institute guidelines.
A total of 4283 non-duplicate Enterobacterales were isolated during the study period (January 2017 to December 2020). Urine was the most common site of infection. E. coli was the most detected isolate as well as the leading pathogen in urine, wounds and surgical sites, and blood. Regarding antimicrobial susceptibility, the mean susceptibility to third generation cephalosporins was 55.53% and a mean extended-spectrum β-lactamases production of 31.2% was measured in E. coli. Mean carbapenem susceptibility was the lowest in K. pneumoniae and E. cloacae. The lowest mean susceptibility to fluoroquinolones was detected in E. coli isolates.
This study identified the predominance of E. coli among Enterobacterales in Lebanese patients, with the urinary tract being the most common site of infection and underlined the high rates of AMR in Enterobacterales in Lebanon.
抗菌药物耐药性（AMR）是一个全球性问题，威胁着针对最严重细菌感染的治疗效果。肠杆菌科中的 AMR 在黎巴嫩非常普遍。然而，最近关于肠杆菌科的分布和相关抗菌药物敏感性的报告很少。
在黎巴嫩 Geitaoui 医疗中心的这项回顾性研究中，收集了所有来自尿液、血液、痰、深部气管抽吸物、支气管肺泡灌洗、伤口、手术部位、组织、体液和中心静脉导管的培养标本的阳性数据，这些标本至少有 4 种细菌分离株（大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌和奇异变形杆菌）之一。所有药敏试验均根据临床和实验室标准协会指南进行。
在研究期间（2017 年 1 月至 2020 年 12 月），共分离出 4283 株非重复肠杆菌科。尿液是最常见的感染部位。大肠埃希菌是最常见的分离株，也是尿液、伤口和手术部位以及血液中的主要病原体。关于抗菌药物敏感性，第三代头孢菌素的平均敏感性为 55.53%，大肠埃希菌中平均产生 31.2%的扩展谱β-内酰胺酶。碳青霉烯类药物的平均敏感性在肺炎克雷伯菌和阴沟肠杆菌中最低。氟喹诺酮类药物的平均敏感性在大肠埃希菌分离株中最低。
本研究确定了大肠埃希菌在黎巴嫩患者肠杆菌科中的优势，尿路感染是最常见的感染部位，并强调了黎巴嫩肠杆菌科中 AMR 的高发生率。
