Dangerous drug-resistant bacteria are spreading in Ukraine

When Pte Oleksander Bezverkhny was transferred to Feofaniya Hospital in Kyiv, few believed that he would survive. The 27-year-old suffered serious injuries to his stomach and his equipment was torn from his buttocks. Both his legs were amputated.

Then, doctors discovered that his disease was resistant to commonly used antibiotics – and the already difficult task of saving his life became hopeless.

Antimicrobial resistance (AMR) is when bacteria evolve and learn how to protect themselves from antibiotics and other drugs, rendering them ineffective.

Ukraine is far from the only country affected by this issue: an estimated 1.4 million people worldwide died of AMR in 2021, and in the UK there were 66,730 serious antibiotic-resistant infections in 2023. However, the war appears to have accelerated the spread of antimicrobial resistance. disease in Ukraine.

Hospitals treating war casualties have shown a significant increase in AMR cases. More than 80% of all patients admitted to Feofaniya Hospital have infections caused by bacteria resistant to antibiotics, according to the deputy chief physician Dr Andriy Strokan.

Surprisingly, antibiotic-resistant infections often originate in hospitals.

Medical workers try to follow hygiene protocols and use personal protective equipment to reduce the spread of the disease but the area can be overwhelmed by war casualties.

Dr. Volodymyr Dubyna, director of the ICU Hospital Mechnikov, said that since the beginning of the Russian invasion, his group alone increased the number of beds from 16 to 50. At present, many workers flee the war or join the army alone, workers. levels are down.

Dr Strokan explained that this could affect the spread of AMR bacteria. “In the operating departments there is one nurse who takes care of 15-20 patients,” he said. “They are physically unable to wash their hands as much and as often as they need to in order to prevent the spread of disease.”

The war situation also means that patients are exposed to more diseases than they would be in peacetime. When a soldier is transferred for medical reasons, he or she often passes through several locations, each with its own unique strains of AMR. Although medical experts say this is unlikely due to the scale of the war, it will only increase the spread of AMR.

This was the case for Pte Bezverkhny who was treated in three different places before arriving at the hospital in Kyiv. Unable to treat with conventional medicine, her condition worsened and she developed sepsis five times.

This is in contrast to other recent conflicts, for example the Afghanistan War, where Western troops are concentrated on the ground and transferred to a European hospital instead of going through different local areas.

This would not be possible in Ukraine because the number of patients has not been seen since the Second World War, according to Dr. Dubyna, whose clinic in Dnipro neighbors the frontline. When his patients are stable enough, he transfers them to another hospital – if it has space – to free up the energy.

“In terms of pathogen control, it means they spread [bacteria] advance. But if it doesn’t happen, we can’t work. So it’s a disaster.”

With so many casualties, Ukraine’s hospitals cannot afford to exclude infected patients – meaning that resistant and dangerous bacteria can spread unchecked.

The problem is that the disease that causes it must be treated with special antibiotics that are on the “reserve” list. But when doctors prescribe these, the bacteria quickly mutate, causing the antibiotics to no longer work.

“We have to balance our scales,” Dr Strokan explains. “On the one hand, we have to save the patient. On the other hand – we don’t have to breed new bacteria that will have antimicrobial resistance.”

In the case of Pte Bezverkhny, the doctors had to use very expensive antibiotics, which volunteers came from abroad. After a year of hospitalization and more than 100 surgeries, his condition is no longer life-threatening.

Doctors managed to save his life. But as pathogens become more widespread, the fight to save others becomes more intense.