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Trends in Enterobacteriaceae Resistance Patterns: A Nine-Year Retrospective Study From North Lebanon
Mazen Zaylaa1, Maya El Bitar1, Ali Jaafar1
1Faculty of Medicine Beirut Arab University Beirut Lebanon.
Health Science Reports
|July 1, 2026
Summary
Antimicrobial resistance in Enterobacteriaceae remains high in North Lebanon, with increasing carbapenem non-susceptibility observed in E. coli. This highlights the need for continued surveillance of antimicrobial resistance (AMR) to inform public health strategies.
Area of Science:
- Microbiology and Infectious Diseases
- Global Health Security
- Clinical Pharmacy and Pharmacology
Background:
- Antimicrobial resistance (AMR) in Enterobacteriaceae is a significant global health concern, exacerbated by antibiotic misuse and inadequate surveillance.
- Intensive care units (ICUs) are critical hotspots for the emergence and spread of antimicrobial resistance (AMR).
- Limited data exists on long-term antimicrobial resistance (AMR) trends in North Lebanon.
Purpose of the Study:
- To assess long-term antimicrobial resistance (AMR) trends in clinically significant Enterobacteriaceae.
- To analyze resistance patterns in two North Lebanese hospitals from 2016 to 2024.
- To compare resistance rates between intensive care unit (ICU) and non-ICU isolates, and hospital-acquired versus community-acquired infections.
Main Methods:
- Retrospective analysis of 14,013 Enterobacteriaceae isolates identified via biochemical testing or MALDI-TOF MS.
- Antimicrobial susceptibility testing performed according to EUCAST standards.
- Statistical analysis using SPSS v23.0 with Chi-square or Fisher's exact tests (p < 0.05).
Main Results:
- Escherichia coli (E. coli) was the most prevalent species (66.4%), followed by Klebsiella pneumoniae (12.4%).
- Carbapenem non-susceptibility in E. coli increased significantly from 2.7% to 4.8% (p < 0.001).
- Higher rates of extended-spectrum beta-lactamase (ESBL) production and multidrug resistance (MDR) were observed in ICU and hospital-acquired infections compared to non-ICU and community-acquired cases, respectively.
Conclusions:
- Enterobacteriaceae isolates in North Lebanon exhibit persistent high beta-lactam resistance and rising carbapenem non-susceptibility, particularly in E. coli.
- The findings underscore the critical need for enhanced antimicrobial resistance (AMR) surveillance in the region.
- This regional data is vital for informing evidence-based clinical practice and public health policies to combat antimicrobial resistance (AMR).
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