Epidemiology of Methicillin-resistant and Methicillin-sensitive Staphylococcus aureus infections in Lebanon


  • Farah Abou-Zeid Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
  • Sara C. Mourani Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
  • jamil M. Kazma Department of Obstetrics & Gynecology, George Washington University School of Medicine, Washington, DC
  • Amal Gharamti Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
  • Mohamad Yasmin Department of Internal Medicine, Case Western Reserve University, Cleveland, OH
  • Salma Jabak Department of Obstetrics & Gynecology, King's College Hospital, London, United Kingdom
  • Tania Baban Department of Ophthalmology, University of Balamand, El Koura, Lebanon
  • Nisreen Sidani Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
  • Zeina A. Kanafani Department of Internal Medicine, American University of Beirut, Beirut, Lebanon https://orcid.org/0000-0001-8814-1286




staphylococcus aureus, methicillin-resistance, antimicrobial-resistant


Background. Methicillin-resistant Staphylococcus aureus (MRSA) is a prevalent pathogen associated with significant morbidity and mortality. In Lebanon, MRSA rates have recently started to rise. We aimed to determine risk factors for acquiring MRSA and Methicillin-sensitive Staphylococcus aureus (MSSA) infections and identify independent risk factors for in-hospital mortality among patients with S. aureus infection. Methods. We used a case-case-control study design that included patients with infections and compared them to uninfected controls. Two multivariable regression models were constructed to determine variables associated with acquiring MRSA and MSSA infections. We explored independent predictors of mortality in the overall population compared with the MRSA subgroup. Results. 356 patients with S. aureus infections were identified and compared to 208 uninfected controls. A recent history of surgery and underlying diabetes were independent risk factors for acquiring both infections. Having a urinary catheter for more than 6 days and steroid therapy were unique risk factors for MRSA infection (aOR 28.1, 95% CI 3.5-223.6 and 3.7, 95% CI 1.6-8.7, respectively). Risk factors exclusively associated with MRSA infection included ICU admission, acute renal failure, and malignancy. Conclusions. Risk factors associated with MRSA infection are distinct from those associated with MSSA infection. This can be used to risk stratify patients and will aid in choosing empirical antibiotic therapy.


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How to Cite

Abou-Zeid, F., Mourani, S. C., Kazma, jamil M., Gharamti, A., Yasmin, M., Jabak, S., Baban, T., Sidani, N., & Kanafani, Z. A. (2023). Epidemiology of Methicillin-resistant and Methicillin-sensitive Staphylococcus aureus infections in Lebanon. Microbes, Infection and Chemotherapy, 3, e1692. https://doi.org/10.54034/mic.e1692