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Introduction: Gram-negative bacteremia is a life-threatening infection with high morbidity and mortality. Its incidence is rising worldwide, and treatment has become more challenging due to emerging bacterial resistance. Little data is available on the burden and outcome of such infections in Lebanon., Methods: We conducted this retrospective study in four Lebanese hospitals. Data on medical conditions and demographics of 2400 patients diagnosed with a bloodstream infection based on a positive blood culture were collected between January 2014 and December 2020., Results: Most bacteremias were caused by Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii, with the more resistant organisms being hospital-acquired. Third-generation cephalosporin and quinolone resistance was steady throughout the study, but carbapenem resistance increased. Mortality with such infections is high, but carbapenem resistance or infection with Pseudomonas or Acinetobacter species were significant risk factors for poor outcomes., Conclusion: This is the first multi-center study from Lebanon on gram-negative bacteremia, resistance patterns, and factors associated with a poor outcome. More surveillance is needed to provide data to guide empirical treatment for bacteremia in Lebanon., (© 2024. The Author(s).)

Acute diarrhea is a prevalent disease worldwide and a cause of mortality in low and middle-income countries. In previous studies, the causative enteropathogen is found in 38% to 58% of patients, leaving a considerable diagnostic gap. In this study, we intend to determine the pathogenic agents responsible for acute diarrhea in patients presenting to the Emergency Departments of several Lebanese hospitals. A total of 100 stool samples were collected between June 2022 and June 2023 from patients presenting with acute diarrhea to the Emergency Departments. Pathogens were detected by multiplex polymerase chain reaction. The average age for the patients was 53 years old. All patients presented with diarrhea, 15 of them had fever associated. In total, 46 patients were admitted to the hospital (70%), among them 80% received Intravenous antibiotics. Campylobacter was the most common agent detected in 36%, followed by Rotavirus 19%, and Noroviruses 15%. The rest was detected at lower percentages. Bacteria accounted for 49% of cases, viruses for 39%, and parasitic infection 6%. Acute diarrhea epidemiology is understudied in Lebanon. This study is the first Lebanese data about acute diarrhea pathogens. Avoiding overuse of antibiotics in bacterial versus viral infections can be achieved while prevention campaigns can raise awareness about food and water safety at the community level., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

This study aims to describe COVID-19 patients characteristics, laboratory and imaging results, and the different outcomes of patients admitted to the Lebanese American University Medical Center-Rizk Hospital over a period of 9 months. In this observational retrospective study, data were obtained from electronic medical records of 491 male and female patients from the ages of 17 to 97. Analysis of the patients was performed in 3 periods: August 2020 to October 20 November 202020 to January 2021 and February 2021 to April 2021 corresponding with 3 waves of newly diagnosed cases during this period. The sample showed a male predominance with an average age of 63. The average hospitalization length was 10.1 days. The majority of patients were discharged to quarantine. The distribution of hospitalized cases was significantly correlated to the monthly distribution of newly COVID-19 cases in Lebanon. There was no significant difference in patient's characteristics between the 3 periods of the study (gender, age, body mass index, smoking, and medical conditions). Clinical presentations of the patients varied between the 3 periods. Similarly, the course and outcome of infection varied. Patients received less oxygen during period 1, while more patients were cured during period 3. This study presents the first Lebanese cohort of COVID-19 patients with their medical background, clinical presentation, laboratory results, radiological findings and course of infection with its outcome. It also shows how the relations between the medical manifestation of the COVID-19 pandemic and the socio-political measures of infection control are deeply intertwined.

Alike many developing countries, Lebanon lacks a national wastewater management strategy that can effectively protect public health and environmental quality. This has led the local communities and municipalities to plan and implement their own arrangements for wastewater treatment systems. However, most municipalities still lack the human and financial resources, management capabilities, and environmental awareness necessary to implement wastewater management in an environmentally sound manner. As such, the effectiveness of these systems, particularly with regard to the quality of the treated effluent, warrants evaluation. Accordingly, a performance evaluation of the treatment/disposal systems, taking three villages in Al-Chouf Caza in Lebanon as a case study, was carried out. The conducted field work, visual assessment, and laboratory analyses of effluent discharges revealed that the existing systems for wastewater treatment in the three villages are either not properly functioning or operational but ineffective and, consequently, hardly achieve any treatment higher than primary. Although developing countries are being encouraged to implement wastewater treatment systems with the promise of financial aid from developed nations, it is important that local conditions are considered carefully to make full use of any aid. It is very crucial to take into account the economic status of the community and the municipality in question. There is no point in adopting the most advanced technology for wastewater treatment if there is no mechanism to ensure maximum efficiency.

Aims: Genotypic profiles of the natural killer cell immunoglobulin-like receptors (KIR) have been reported to vary among different ethnic groups and variable clinical entities. This study represents the second report on its distribution among patients with Behçet's disease (BD). We studied 43 unrelated Lebanese Behçet's patients, had their DNA typed using sequence-specific primer technique for the presence of 16 KIR genes and pseudogenes loci, and compared them to the general Lebanese population., Results: In addition to sharing common features with the general population, the AA genotype was still the most frequent--however, with five new KIR profiles identified. There was no statistically significant distribution of the different KIR genes between the cases (BD patients) and controls (Lebanese population); however, KIR3DP1*001/002 was found to be significantly different between the BD patients and the Lebanese population, but this significance was lost after correction for all KIR loci., Conclusion: The results lead to an interesting future research question of whether or not KIR genotype is involved in the predisposition to or pathogenesis of BD especially that a pseudogene is controversially in question. This is the second report that describes the KIR genotypic profile in such an important clinical disease but the first to shed a light on the possible role of a pseudogene.

The recent global increase in argileh use represents the modern renaissance of an old public health threat and a new tobacco epidemic. This study examined argileh smoking knowledge and attitudes in a sample of university students in Beirut as determinants of argileh smoking. Data were collected cross-sectionally through self-administered questionnaires from 416 students at the American University of Beirut through stratified cluster sampling. The proportion of ever-smokers in this study was 43%, compared with the 30% reported 4 years ago. A total of 28.3% of the surveyed students were current argileh smokers, and the average initiation age was 16 years. Compared with argileh smokers, significantly greater proportions of nonsmokers had positive attitudes about argileh banning and more accurate knowledge about argileh. Argileh smoking among Lebanese young is on the rise. Students demonstrated partial knowledge and moderate to favorable attitudes concerning argileh smoking. Possible public health interventions are discussed in light of the social and cultural context of argileh use to neutralize this emerging global public health threat.

Questionnaire responses from mothers of 1,039 Lebanese 3-9 yr olds were used to study the effects of children's experiences in war on their emotional and social behaviour. Children who had experienced death of a family member, forced displacement of family, or destruction of home or had witnessed death (30% of sample) were about 1.7 times more likely than those who had not to exhibit nervous, regressive, aggressive and depressive behaviour reactions to a general war stress situation (shelling). Findings are discussed with respect to: (a) research relating stressful life events to onset of psychological disorder and (b) societal implications of youngsters' being repeatedly exposed to models of aggression and the violent resolution of interpersonal disputes.