Alarming Antibiotic Resistance Levels Found in Ukrainian Wounded

Topic: Health and Disability
Author: Lund University
Published: 2023/06/29
Publication Type: Observational Study - Peer-Reviewed: Yes
Contents: Summary - Definition - Introduction - Main - Related

Synopsis: Researchers assisting microbiologists in Ukraine investigate bacterial resistance among wounded treated in hospitals reveal many patients exhibited extremely high level of antibiotic resistance. They observed that several the Gram-negative bacteria exhibited resistance to broad-spectrum antimicrobial agents, including newly developed enzyme-inhibiting antibiotics that are not yet available in the market. While isolated cases have been documented in China, the magnitude of this situation surpasses anything seen before. There is an evident risk of further spread of resistant bacteria - and this threatens the entire European region.

Defining Klebsiella Pneumoniae

Klebsiella Pneumoniae: Klebsiella pneumoniae is a Gram-negative, non-motile, encapsulated, lactose-fermenting, facultative anaerobic, rod-shaped bacterium. It appears as a mucoid lactose fermenter on MacConkey agar. When bacteria such as Klebsiella pneumoniae produce an enzyme known as a carbapenemase then the class of antibiotics called carbapenems will not work to kill the bacteria and treat the infection. Klebsiella species are examples of Enterobacterales, a normal part of the human gut bacteria, that can become carbapenem-resistant. CRE, which stands for carbapenem-resistant Enterobacterales, are an order of germs that are difficult to treat because they have high levels of resistance to antibiotics. Unfortunately, carbapenem antibiotics often are the last line of defense against Gram-negative infections that are resistant to other antibiotics.

Introduction

"Highly multidrug-resistant Gram-negative bacterial infections in war victims in Ukraine, 2022" - The Lancet Infectious Diseases.

Researchers led by Lund University in Sweden have assisted microbiologists in Ukraine in investigating bacterial resistance among the war-wounded patients treated in hospitals. The results, which were recently published in The Lancet Infectious Diseases, reveal that many of the patients were affected by bacteria that exhibited an extremely high level of antibiotic resistance.

Main Digest

"I am quite thick-skinned and have witnessed numerous situations involving patients and bacteria. However, I must admit that I have never encountered bacteria as resistant as this before", says Kristian Riesbeck, professor of Clinical Bacteriology at Lund University.

There was never any doubt about helping out when Dr. Oleksandr Nazarchuk, a microbiologist at a university in Vinnytsia, Ukraine, got in touch, says Kristian Riesbeck. Help was needed in Ukraine to assess the extent of antibiotic resistance in bacteria among severely injured patients in hospital.

In addition to all the human suffering caused by the war in Ukraine, another battle is being fought - an invisible war against resistant bacteria. This became evident when Kristian Riesbeck and his research colleagues analysed patient samples from seriously wounded patients, many of whom had burn injuries, in Ukraine. The patients had acquired infections while in hospital, primarily due to the overwhelmed wards and destroyed infrastructure.

Samples were collected from a total of 141 war victims, 133 adults who sustained injures during the war and eight infants diagnosed with pneumonia. These patients were admitted to three different hospitals in Ukraine, where they received emergency surgeries and intensive care to address their conditions.

"We observed that several the Gram-negative bacteria exhibited resistance to broad-spectrum antimicrobial agents, including newly developed enzyme-inhibiting antibiotics that are not yet available in the market. Moreover, nearly ten per cent of the samples contained bacteria that demonstrated resistance even to "our last-resort" antibiotic, colistin. While we have encountered similar cases in India and China before, nothing compares to the extent of resistance observed in this study. As much as six per cent of all the samples contained bacteria resistant to every antibiotic we tested," says Kristian Riesbeck.

He emphasizes that this clearly highlights the challenges posed by resistant bacteria in times of war. In particular, Kristian Riesbeck expresses concern regarding the resistance displayed by Klebsiella pneumoniae bacteria, as they have the potential to cause illness in individuals with a healthy and well-functioning immune system.

"This makes me very worried. It's rare to encounter Klebsiella with such high levels of resistance, and it was not what we anticipated. While isolated cases have been documented in China, the magnitude of this situation surpasses anything we have seen before. While many countries are providing military aid and resources to Ukraine, it is equally crucial to assist them in addressing this ongoing situation. There is an evient risk of further spread of resistant bacteria, and this threatens the entire European region," remarks Kristian Riesbeck.

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Attribution/Source(s):

This peer reviewed publication was selected for publishing by the editors of Disabled World due to its significant relevance to the disability community. Originally authored by Lund University, and published on 2023/06/29, the content may have been edited for style, clarity, or brevity. For further details or clarifications, Lund University can be contacted at lunduniversity.lu.se. NOTE: Disabled World does not provide any warranties or endorsements related to this article.

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