Prevalence and antimicrobial resistance of gram-positive pathogens in Lebanon: The need for surveillance and stewardship

Background: Resistance in Gram-positive organisms, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE), poses a significant healthcare challenge globally. However, data on these organisms in Lebanon remain limited. This retrospective study aimed t...

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Main Authors: Yara Khachab, Racha Khoumassi, Elie Salem Sokhn
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:New Microbes and New Infections
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Online Access:http://www.sciencedirect.com/science/article/pii/S2052297525000265
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author Yara Khachab
Racha Khoumassi
Elie Salem Sokhn
author_facet Yara Khachab
Racha Khoumassi
Elie Salem Sokhn
author_sort Yara Khachab
collection DOAJ
description Background: Resistance in Gram-positive organisms, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE), poses a significant healthcare challenge globally. However, data on these organisms in Lebanon remain limited. This retrospective study aimed to assess the prevalence and antimicrobial resistance patterns of Staphylococcus aureus (S. aureus), coagulase-negative Staphylococci (CoNS), and Enterococcus spp. in clinical infections at the Lebanese Hospital Geitaoui – UMC from 2017 to 2023. Methods: A total of 2676 isolates were collected from urine, blood, respiratory specimens, and other infection sites. Bacterial identification was performed following WHO clinical bacteriology procedures, utilizing gram staining, catalase and coagulase tests, and biochemical assays. Antimicrobial susceptibility testing was conducted using the Kirby-Bauer disk diffusion method and minimum inhibitory concentration (MIC) analysis, interpreted according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Statistical analyses were performed using SPSS® version 24, with significance set at p < 0.05. Results: CoNS were the most prevalent (42.83 %), followed by Enterococcus spp. (28.81 %) and S. aureus (28.36 %). Blood cultures had the highest isolation rates (29.04 %), predominantly CoNS (76.45 %). Enterococcus spp. dominated urinary tract infections (85.01 %), while S. aureus was prevalent in wound/surgical site infections (59.23 %). Gender-specific trends showed CoNS and S. aureus more in males, while Enterococcus spp. infections were more common in females. Conclusion: This study provides valuable insights into the prevalence and resistance patterns of Gram-positive pathogens in a Lebanese hospital setting. The findings highlight the need for continuous surveillance and stringent antibiotic stewardship to combat antimicrobial resistance effectively.
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spelling doaj-art-82ca8b7eb5b744f7a61b48f04b1cab5a2025-08-20T03:10:21ZengElsevierNew Microbes and New Infections2052-29752025-06-016510158810.1016/j.nmni.2025.101588Prevalence and antimicrobial resistance of gram-positive pathogens in Lebanon: The need for surveillance and stewardshipYara Khachab0Racha Khoumassi1Elie Salem Sokhn2Laboratory Department, Lebanese Hospital Geitaoui-University Medical Center, Beirut, LebanonDepartment of Laboratory and Transfusion Medicine, Lebanese University, Faculty of Medical Sciences, Beirut, LebanonLaboratory Department, Lebanese Hospital Geitaoui-University Medical Center, Beirut, Lebanon; Molecular Testing Laboratory, Medical Laboratory Department, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon; Corresponding author. Molecular Testing Laboratory, Medical Laboratory Department, Faculty of Health Sciences, Beirut Arab University, Beirut, LebanonBackground: Resistance in Gram-positive organisms, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE), poses a significant healthcare challenge globally. However, data on these organisms in Lebanon remain limited. This retrospective study aimed to assess the prevalence and antimicrobial resistance patterns of Staphylococcus aureus (S. aureus), coagulase-negative Staphylococci (CoNS), and Enterococcus spp. in clinical infections at the Lebanese Hospital Geitaoui – UMC from 2017 to 2023. Methods: A total of 2676 isolates were collected from urine, blood, respiratory specimens, and other infection sites. Bacterial identification was performed following WHO clinical bacteriology procedures, utilizing gram staining, catalase and coagulase tests, and biochemical assays. Antimicrobial susceptibility testing was conducted using the Kirby-Bauer disk diffusion method and minimum inhibitory concentration (MIC) analysis, interpreted according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Statistical analyses were performed using SPSS® version 24, with significance set at p < 0.05. Results: CoNS were the most prevalent (42.83 %), followed by Enterococcus spp. (28.81 %) and S. aureus (28.36 %). Blood cultures had the highest isolation rates (29.04 %), predominantly CoNS (76.45 %). Enterococcus spp. dominated urinary tract infections (85.01 %), while S. aureus was prevalent in wound/surgical site infections (59.23 %). Gender-specific trends showed CoNS and S. aureus more in males, while Enterococcus spp. infections were more common in females. Conclusion: This study provides valuable insights into the prevalence and resistance patterns of Gram-positive pathogens in a Lebanese hospital setting. The findings highlight the need for continuous surveillance and stringent antibiotic stewardship to combat antimicrobial resistance effectively.http://www.sciencedirect.com/science/article/pii/S2052297525000265ResistanceCoagulase-negative Staphylococcigram-positive organismsMethicillin-resistant Staphylococcus aureusVancomycin-resistant Enterococci
spellingShingle Yara Khachab
Racha Khoumassi
Elie Salem Sokhn
Prevalence and antimicrobial resistance of gram-positive pathogens in Lebanon: The need for surveillance and stewardship
New Microbes and New Infections
Resistance
Coagulase-negative Staphylococci
gram-positive organisms
Methicillin-resistant Staphylococcus aureus
Vancomycin-resistant Enterococci
title Prevalence and antimicrobial resistance of gram-positive pathogens in Lebanon: The need for surveillance and stewardship
title_full Prevalence and antimicrobial resistance of gram-positive pathogens in Lebanon: The need for surveillance and stewardship
title_fullStr Prevalence and antimicrobial resistance of gram-positive pathogens in Lebanon: The need for surveillance and stewardship
title_full_unstemmed Prevalence and antimicrobial resistance of gram-positive pathogens in Lebanon: The need for surveillance and stewardship
title_short Prevalence and antimicrobial resistance of gram-positive pathogens in Lebanon: The need for surveillance and stewardship
title_sort prevalence and antimicrobial resistance of gram positive pathogens in lebanon the need for surveillance and stewardship
topic Resistance
Coagulase-negative Staphylococci
gram-positive organisms
Methicillin-resistant Staphylococcus aureus
Vancomycin-resistant Enterococci
url http://www.sciencedirect.com/science/article/pii/S2052297525000265
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AT eliesalemsokhn prevalenceandantimicrobialresistanceofgrampositivepathogensinlebanontheneedforsurveillanceandstewardship