Staphylococcus aureus is an important human pathogen and is a growing public health concern. In this study, 130 S. aureus, 93 methicillin-resistant S. aureus (MRSA) and 37 methicillin-sensitive S. aureus (MSSA), clinical isolates recovered from Lebanon were typed by protein A gene (spa) sequencing and multi-locus sequence typing (MLST). Forty-eight different spa types were identified and clustered into 30 different groups. MLST revealed 10 sequence types (STs) among the isolates. There were eight major MRSA clones defined as isolates with the same ST and the same SCCmec type. The majority of the PVL-positive isolates (53%) were ST80-MRSA-IVc. Systematic surveillance of both hospital and community isolates in Lebanon together with measures designed to limit the spread are required.

Molecular characterization of Staphylococcus aureus is of both clinical and infection control importance. Virulence determinants using PCR and multiple drug resistance profiles were studied in 130 S. aureus isolates. PCR-RFLP analysis of the 16S-23S DNA spacer region was done to investigate the level of 16S-23S ITS (internal transcribed spacer) polymorphism. Methicillin-resistant S. aureus (MRSA), which represented 72% of the studied isolates, showed multiple drug resistance with 18% being resistant to 10-18 of the drugs used compared to a maximum resistance to 9 antibiotics with the methicillin sensitive S. aureus (MSSA) isolates. Exfoliative toxin A (ETA) was more prevalent than B (ETB) with virulent determinants being additionally detected in multiple drug-resistant isolates. 16S-23S ITS PCR-RFLP combined with sequencing of the primary product was successful in generating molecular fingerprints of S. aureus and could be used for preliminary typing. This is the first study to demonstrate the incidence of virulent genes, ACME, and genetic diversity of S. aureus isolates in Lebanon. The data presented here epitomize a starting point defining the major genetic populations of both MRSA and MSSA in Lebanon and provide a basis for clinical epidemiological studies.

SUMMARYWe have examined the male-specific phylogeography of the Levant and its surroundings by analyzing Y-chromosomal haplogroup distributions using 5874 samples (885 new) from 23 countries. The diversity within some of these haplogroups was also examined. The Levantine populations showed clustering in SNP and STR analyses when considered against a broad Middle-East and North African background. However, we also found a coastal-inland, east-west pattern of diversity and frequency distribution in several haplogroups within the small region of the Levant. Since estimates of effective population size are similar in the two regions, this strong pattern is likely to have arisen mainly from differential migrations, with different lineages introduced from the east and west.

A controlled study was conducted in Lebanon over a period of 12 months to determine bacterial regrowth in a small network supplying the Beirut suburb of Naccache that had a population of about 3,000. The residential area, which is fed by gravity, is supplied twice a week with chlorinated water from two artesian wells of a confined aquifer. A significant correlation was detected between the turbidity and the levels of heterotrophic plate count bacteria (HPC) in the samples from the distribution network as well as from the artesian wells. However, a negative significant correlation was found between the temperature and the HPC count in the samples collected from the source. A statistically significant increase in counts, possibly due to regrowth, was repeatedly established between two sampling points lying on a straight distribution line but 1 km apart. Faecal coliforms were detected in the source water but none in the network except during a pipe breakage incident with confirmed Escherichia coli reaching 40 CFU/100 mL. However, coliforms such as Citrobacter freundii, Enterobacter agglomerans, E. cloacae and E. skazakii were repeatedly isolated from the network, mainly due to inadequate chlorination. A second controlled study was conducted to determine the effect of storage on the microbial quality of household storage tanks (500 L), which were of two main types - galvanized cast iron and black polyethylene. The mean bacterial count increased significantly after 7 d storage in both tank types. A significant difference was found in the mean HPC/mL between the winter and the summer. Highest counts were found April-June although the maximum temperature was reported later in the summer. A positive correlation was established between the HPC/mL and pH, temperature and storage time.

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