Antimicrobial resistance of enterococci in Lebanon

There is little information on the types of Enterococcus spp and their anti biotic resistance patterns in Lebanon. One hundred and fifty-three consecut ive clinical enterococcal isolates collected between 1998 and 1999 were tes ted against 11 antimicrobial agents using disk diffusion and the Etest. The isolates were identified by conventional methods and API-Strep and were Fo und to consist of Enterococcus faecalis (72.5%), Enterococcus faecium (22.9 %), Enterococcus avium (3.2%) and Enterococcus gallinarum (1.3%). The perce nt of resistant strains of E. faecalis and E. faecium respectively were. am picillin 0.9 and 14%, erythromycin 59% and 40% tetracycline 72% and 34%, ch loramphenicol 32 and 11%, rifampin 36% and 57%, ciprofloxacin. 23% and 34%. norfloxacin 22 and 8%. High level aminoglycoside (HLA) resistance was foun d in 19% E. faecalis and 9% E. faecium for gentamicin and 36%, and 26% for streptomycin. Excellent correlation was observed between the high level dis k tests and the Etest in the detection of HLA resistance but not with the r egular disks. None of the isolates showed resistance to vancomycin or teico planin except for one E. gallinarum isolate which showed intermediate resis tance (MIC 16 mg/l) to vancomycin. These variable antimicrobial rates of re sistance suggest a surveillance programme for antimicrobial resistance in t his country would be helpful to help control infection. guide empirical ant ibiotic therapy and implement a policy of antibiotic usage. (C) 2001 Elsevi er Science B.V. and International Society for Chemotherapy All rights reser ved.