Antimicrobial resistance is closely linked to antimicrobial use and is a growing concern worldwide. Antimicrobial resistance increases healthcare costs substantially in many countries, including Lebanon. National data from Lebanon have, in the most part, been limited to a few academic hospitals. The Lebanese Society of Infectious Diseases conducted a retrospective study to better describe the antimicrobial susceptibility patterns of bacterial isolates in Lebanon. Data were based on records retrieved from the bacteriology laboratories of 16 different Lebanese hospitals between January 2011 and December 2013. The susceptibility results of a total 20684 Gram-positive and 55594 Gram-negative bacteria were analyzed. The prevalence rate of methicillin-resistant Staphylococcus aureus was 27.6% and of vancomycin-resistant Enterococcus spp was 1%. Streptococcus pneumoniae had susceptibilities of 46% to oxacillin, 63% to erythromycin, and 98% to levofloxacin. Streptococcus pyogenes had susceptibilities of 94% to erythromycin and 95% to clindamycin. The mean ampicillin susceptibility of Haemophilus influenzae, Salmonella spp, and Shigella spp isolates was 79%, 81.3%, and 62.2%, respectively. The extended-spectrum beta-lactamase production rate for Escherichia coli was 32.3% and for Klebsiella spp was 29.2%. Acinetobacter spp showed high resistance to most antimicrobials, with low resistance to colistin (17.1%). Pseudomonas spp susceptibilities to piperacillin-tazobactam and imipenem were lower than 80% (79.7% and 72.8%, respectively). This study provides population-specific data that are valuable in guiding antimicrobial use in Lebanon and neighbouring countries and will help in the establishment of a surveillance system for antimicrobial resistance following the implementation of a nationwide standardization of laboratory methods and data entry.
Recently, there has been an increasing interest in integrating pulse flours into pastries and baked products to improve their nutritional and health benefits. “Mankoushe,” a popular Lebanese pastry made up of refined wheat flour was enriched with chickpea flour that is of better nutritional value, and its postprandial glycemia, insulinemia, lipidemia and appetite measures were monitored. A randomized cross-over study was performed on sixteen healthy Lebanese females, age (years): 22.90 ± 3.00, and BMI (kg/m2): 22.70 ± 2.65. Over-night fasted females were asked to consume two iso-energetic meals (201 g; 681 kcal) on two separate days, three days apart. One meal was the “Regular Mankoushe” (RM) made with white flour 100%, and the second meal was the “Chickpeas Mankoushe” (CM) made with a mixture of wheat/chickpea flour (70/30). Blood samples were collected 15 min before meal ingest and at 30, 90, 150 and 210 min postprandial. Glucose, insulin, triglycerides (TG), ghrelin, and glucagon-like peptide 1 (GLP-1) plasma levels were measured. Subjective appetite rating and food intake were also assessed. Incorporation of pre-processed chickpea flour into “Mankoushe” as 30% of the dough was associated with a modest reduction in both glucose and insulin levels, and TG was minimally affected. At the level of appetite hormones, changes in GLP-1 were similar, whereas the reduction in ghrelin was significantly lower after the RM meal and thus favored a higher satiating effect compared to CM. This was not paralleled by a similar change in subjective appetite scores and subsequent energy intake. In conclusion, findings suggest that pre-processed chickpea flour could be a promising functional ingredient of traditional pastries to improve their nutritional quality. Nevertheless, further investigations are warranted regarding its satiating effect.
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