There war between Russia and Ukraine has been going on since February 2022. More than 1,000 days of incessant attacks have already caused hundreds of thousands of injuries on the Ukrainian side. An enormous burden for any health system. But especially for that of a country at war, where hospitals and other health centers are frequently targeted by the invader's missiles. This situation makes it difficult, if not impossible, to properly treat all the wounded... and to isolate those infected with antibiotic-resistant bacteria. Facilitating the spread of these bacteria, which are becoming more and more resistant, but also more and more virulent, according to a study published on October 11, 2024 in the Journal of Infection by researchers from Lund University in Sweden, in collaboration with several health centers in Ukraine.
Bacteria potentially resistant to all antibiotics
One of these bacteria is Klebsiella pneumoniae, which, as its name suggests, attacks the lungs. Strains of this bacteria are known for their antibiotic resistance, that is, their ability to resist antibiotics. In the first six months of the war, participating hospitals identified 37 patients infected with this bacteria. A quarter of them were resistant to the antibiotic colistin, which is used when other antibiotics fail. These bacteria are therefore potentially resistant to all available antibiotics.
“ All strains studied carried genes associated with antibiotic resistance, and a quarter of them appear to be resistant to all current antibiotics., resume in a communicates Kristian Riesbeck, professor of clinical bacteriology at Lund University and director of the study. Infections caused by these bacteria are becoming very difficult, if not impossible, to treat with the drugs we have today."
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These resistant bacteria are also more virulent.
In addition to their antibiotic resistance, these colistin-resistant strains also carry genes associated with increased virulence. This was not the case for most strains without this resistance. And these resistant strains also survived better against innate immunity proteins, our body's first line of defense against infection.
The researchers tested their virulence in the laboratory, on mice and on moth larvae (of the species Mellonella Gallery). The resistant strains infected the lungs of these rodents more easily than strains without this resistance. And larvae infected with these strains had a lower survival rate than those infected with the other strains. That is, these strains, potentially resistant to all antibiotics, are also more virulent.
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“ Often, bacteria that become antibiotic-resistant use so many resources to resist antibiotics that they lose their ability to infect and cause disease. But we may have underestimated these bacteria, because several of the strains we detected in Ukraine carry genes for antibiotic resistance, but also for virulence.", warns Kristian Riesbeck. However, this increased virulence has not yet been confirmed in patients. Further studies, with a larger cohort, will be necessary to confirm these worrying results.
A danger for the country and its neighbors
Two years later, the number of patients infected with these antibiotic-resistant strains has undoubtedly increased considerably. This represents a danger for the country, but also for its neighbors (and the rest of the continent) if it ever spreads beyond its borders. This is something that won't just go away over time. As long as patients aren't treated properly and isolated if infected with these bacteria, the spread will continue., warns Kristian Riesbeck. This is what happens when a health system collapses.. »
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