Extreme antibiotic resistance in war-torn Ukraine

Published 24 July 2023
- By Editorial Staff
Klebsiella pneumoniae occurs in the intestinal system and can cause various infections.

A group of Swedish researchers from Lund University and the EUCAST laboratory in Växjö, together with Ukrainian microbiologists, have mapped the antibiotic resistance of bacteria in war wounded in Ukrainian hospitals.

The results show that many patients had bacteria described as “extremely resistant to antibiotics” – and there are concerns about a possible spread to Europe.

I’m pretty thick-skinned and I’ve seen most things in terms of patients and bacteria, but I’ve never seen such resistant bacteria, says Kristian Riesbeck, professor of clinical bacteriology at Lund University and senior physician at Labmedicin Skåne.

The samples were taken from 141 injured Ukrainians, including 133 adults wounded in the war and eight newborn babies with pneumonia. The patients had been treated in three different Ukrainian hospitals, receiving emergency surgery or intensive care.

We saw that several of the Gram-negative bacteria were resistant to broad-spectrum antibiotics and also to new enzyme-inhibiting antibiotics that are not yet on the market; almost ten percent of the samples contained bacteria that were also resistant to the ‘antibiotic of last resort,’ colistin. We have seen some of this in India and China, but nothing like this. A full 6% of all samples were resistant to all the antibiotics we tested, says Riesbeck.

The Klebsiella pneumoniae bacteria and their resistance are of particular concern because they can cause severe disease even in previously healthy people with well-functioning immune systems.

That makes me very worried. Resistant Klebsiella like this is rare and not something we expected. Isolated cases have been described in China, but not on this scale. Many countries are now sending weapons and supplies to Ukraine, but this situation is just as important to help Ukraine for the future. There is an obvious risk that resistant bacteria will spread further, threatening the whole of Europe.

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