Abstract
Background. Antimicrobial resistance is a major public health problem worldwide. Numerous epidemiological studies reported that Lebanon is affected with high levels of antibiotic resistance. The aim of this study is to determine the prevalence and antibiotic susceptibility patterns of carbapenem resistant Gram negative bacteria in North Lebanon during the period 2015-2017.
 Methods. Carbapenem resistant Gram negative bacteria were isolated from patients referring to Nini hospital and Youssef hospital center. Identification and antibiotic susceptibility testing were performed through conventional tools according to the manufacturer’s recommended procedures and the recommendations of the European Committee on Antimicrobial Susceptibility Testing, respectively.
 Results. Overall, a total of 290 carbapenem resistant Gram negative bacteria were isolated. Escherichia coli was predominant and represented 39.3% of all isolates, followed by Pseudomonas aeruginosa (24.8%), Acinetobacter baumannii (22.8%), Klebsiella spp. (8.6%), Enterobacter spp. (6.6%), Pantoea spp. (1%), and Proteus vulgaris (0.3%). Our findings showed an alarming increase in the prevalence of carbapenem resistant bacteria every year. On the other hand, colistin, tigecycline, amikacin and fosfomycin remain the most effective agents against carbapenem resistant Gram negative bacteria.
 Conclusion. This study provided important new laboratory data that could support specialists in infectious diseases in North Lebanon to take the appropriate decision in the treatment of patients at risk for infections with carbapenem resistant Gram negative germs.
Highlights
Antimicrobial resistance (AMR) is a major ongoing public health problem worldwide
This study provided important new data to clinicians in North Lebanon in order to take the appropriate decision in the treatment of patients at risk for infections with carbapenem-resistant
High levels of AMR were reported in these countries, and were associated with the emergence of pan-drug resistant (PDR)
Summary
Antimicrobial resistance (AMR) is a major ongoing public health problem worldwide. High levels of AMR were reported in these countries, and were associated with the emergence of pan-drug resistant (PDR). The causes of AMR in middle and low income countries associated with complex issues, including bad behaviors towards antibiotic use among both health care professionals and general population, limited diagnostic facilities, high spread of counterfeit medicines, excessive non-human use of antibiotics in food and agriculture, and absence of a national action plan for antimicrobial resistance [2]. Numerous epidemiological studies reported that Lebanon is affected with high levels of antibiotic resistance. The aim of this study is to determine the prevalence and antibiotic susceptibility patterns of carbapenem-resistant Gram-negative bacteria in North Lebanon during the period 2015-2017
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