A joint study by researchers from BAU and AUB warns the Lebanese against the emergence of a gene resistant to the most important antibiotic used at hospitals

A scientific study has warned of the widespread use of the potent antibiotic, COLISTIN, in animal and poultry farms as a preventive and non-therapeutic medicine, which may contribute to the development of resistant genes and their transmission to the Lebanese population.

COLISTIN is considered the last-resort antibiotic against multidrug-resistant (MDR) Gram-negative bacterial pathogens, and is used exclusively at hospitals.

The study warned that the availability of COLISTIN for animal farming contributes to the emergence and dissemination of the mcr-1 COLISTIN-resistant gene in Lebanon and its transmission to humans, which threatens effective interventions against multi-drug resistant (MDR) bacterial infections in humans.

The results were based on scientific research indicating the possibility of the transmission of COLISTIN resistance via lateral gene transfer which is spreading globally. The study alerted against the transmission of the mcr-mediated colistin resistant gene to the Lebanese population through the consumption of different animal products of Lebanese origin, exposing them to hazardous health risks.

The joint study by Dr. Mohammed Ali Hijazi from the Faculty of Pharmacy-Beirut Arab University and Dr. Issmat Kassem from the Faculty of Agricultural and Food Sciences-American University of Beirut, which was published in the Journal of Global Antimicrobial Resistance, documented the availability of more than twelve different over-the-counter drug brands containing COLISTIN in the market which are readily and legally available for the veterinary and animal farming. These drugs were advertised for the treatment and prevention of cryptic, non-specified and/or a wide range of diseases mainly in poultry.

The results showed that the number of patients using colistin is increasing dramatically in Lebanon and has reached about 2766 patients in 2017 (0.046% of Lebanese population) which is five times the number in 2010, indicating that the population is becoming more COLISTIN-dependent. Therefore, the causes of its resistance should be reduced in patients.

This study represents the first attempt to evaluate colistin consumption in humans and to identify potential risky agricultural and animal farming practices that might lead to increased resistance, which jeopardises the medical efficacy of this important antibiotic in Lebanon. The study mainly aims to highlight the factors that may be driving the spread of mcr and COLISTIN resistance in Lebanon, which is facing significant challenges in infrastructure, resource management and health systems.

The study recommended the establishment of a surveillance program on colistin availability and consumption in humans and animals. This should be under the jurisdiction of the Ministries of Health and Agriculture, and it should mandate

1- Proper documentation of the import and consumption of colistin on a public server

2- Illegalisation of the use of colistin without medical and/or veterinary prescription

3- Phasing out colistin from controversial animal farming practices

The full study was published in the Q2 scientific Journal of Global Antimicrobial Resistance and is available on the following link: https://doi.org/10.1016/j.jgar.2019.01.019