Antimicrobial-resistant bacterial infections spreading in Ukraine amid war with Russia, CDC says

Dangerous antimicrobial-resistant bacteria are spreading among patients in Ukraine amid the country's war with Russia, new federal data shows.

High rates of antimicrobial resistance (AMR) before Russia's invasion of Ukraine in February 2022, along with a rise in traumatic wounds and overwhelmed health care systems, has led to increased detection of multi-drug resistant infections in Ukraine and surrounding countries, according to a new report published Thursday by the Centers for Disease Control and Prevention (CDC).

Antimicrobials are medicines used to prevent and treat infectious diseases and include antibiotics, antivirals, antifungals and antiparasitics.

AMR occurs when bacteria, viruses, fungi and parasites stop responding to the drugs, causing the infections to become difficult, or even impossible, to treat.

AMR is considered one of the top global public health threats, according to the World Health Organization. Bacterial AMR causes more deaths around the world than HIV or malaria, according to several studies.

For the report published Thursday, the Center for Public Health of Ukraine (UPHC) and regional partners looked at infections in three regional hospitals in the Ternopi and Khmelnytskyi regions in western Ukraine and the Vinnytsia region in western-central Ukraine. The data was then reviewed by the CDC.

Between November and December 2022, of 353 patients surveyed, 50, or 14% of, patients on surveyed wards had health care-associated infections and, of that group, there were high rates of antimicrobial resistance, according to the report.

Of the AMR group, 60% had an infection with an organism resistant to carbapenems, a class of antibiotics. Among patients with Klebsiella pneumoniae, a common type of bacteria found in the intestines that can become dangerous if it spreads, all were resistant to carbapenems and third-generation cephalosporins, another class of antibiotics, the data showed.

In comparison with a European Union-wide survey from 2016 to 2017, just 5.5% of patients had health care-associated infections and, of those related to a family of bacteria that include Klebsiella, just 6.2% were resistant to carbapenems, according to the report.

The report also found gaps in infection prevention and control, as well as laboratory capacity, which raises the risk of delaying diagnosing and causing these organisms to spread.

The authors say more capacity is needed to prevent, detect and respond to antimicrobial resistance to "save lives within Ukraine and limit international spread."

Among the hospitals in the regions surveyed, the UPHC is working to improve this detection by creating routine surveillance, upgrading laboratory equipment, providing technical training for staff and increasing availability and use of hand-hygiene disinfectants, according to the report.

Partners are also working to help provide Ukraine with additional supplies due to increased demand during wartime and to help laboratories be capable of testing for bacterial susceptibility to newer-generation antibiotics.

"Antimicrobial resistance is an urgent global public health threat," the CDC said in a release. "During times of war, this threat can be intensified because of challenges conflicts pose for health care system infrastructure. Collaborative efforts are underway to strengthen health care capacity for infection prevention and control, laboratory detection of antimicrobial resistance, and clinical management of infected patients. These efforts need ongoing support to be scaled nationally."