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Aim:We sought to provide first insights into the epidemiology and antifungal susceptibility patterns of the aspergilli in Lebanon. Materials & methods:After species identification, antifungal susceptibility was investigated according to EUCAST recommendations. CYP51Agene was sequenced in resistant isolates and its expression level was evaluated by Reverse transcription-quantitative PCR. Results:Among the 73 Aspergillusisolates studied (mostly from ears), the predominant species was Aspergillus niger(54.8%). The overall drug resistance was highest for amphotericin B (38.4%), followed by itraconazole (31.5%), posaconazole (30.1%) and voriconazole (23.3%). In addition, CYP51Agene mutations were not the major cause of azole resistance among these isolates. Conclusion:Our findings indicate the paramount need for an integral One Health strategy and a national reference center for invasive mycoses and antifungals.

Aim:We sought to investigate the genetic epidemiological relatedness of carbapenem-resistant Acinetobacter baumannii(CRAB) strains of a suspected outbreak in a Lebanese tertiary care hospital to implement necessary infection prevention and control measures. Methods:Twenty-eight nonduplicate CRAB isolates detected among hospitalized patients between January 2016 and July 2017 were studied by real-time polymerase chain reaction (PCR), pulsed-field gel electrophoresis and multilocus sequence typing analyses. Results:Twenty-seven isolates harbored blaOXA-23, of which one also carried blaNDM-1. The isolates distributed temporally in two presumably episodes were stratified by pulsed-field gel electrophoresis into many clusters. Although several clones have become endemic in the hospital, we have rapidly implemented appropriate infection prevention and control measures, achieving full eradication from August 2017 to November 2019. Conclusion:We have successfully investigated and controlled a polyclonal outbreak of OXA-23 producing ST2 CRAB.