In brief
In Ukraine, the war has accelerated the spread of multi-resistant infections, challenging healthcare providers who are struggling to treat injured soldiers. As hospitals face overwhelming patient influxes and staffing shortages, the risk of antimicrobial resistance grows, complicating medical treatment and recovery efforts.
The ongoing war in Ukraine has not only taken a devastating toll on the nation’s infrastructure and population but has also triggered an alarming surge in drug-resistant infections among wounded soldiers. Before Pte Oleksander Bezverkhny was evacuated to the Feofaniya Hospital in Kyiv, few thought he would survive his extensive injuries, including severe abdominal trauma and bilateral amputations. Unfortunately, his decline was exacerbated when doctors discovered his infections were resistant to standard antibiotics.Antimicrobial resistance (AMR) occurs when bacteria evolve to withstand the effects of medications, rendering them ineffective. This troubling trend isn't unique to Ukraine; a reported 1.4 million global deaths were linked to AMR infections in 2021, including tens of thousands of antibiotic-resistant cases reported in the UK this year. However, the war in Ukraine appears to have exacerbated the situation. According to Dr. Andriy Strokan, deputy chief physician at Feofaniya Hospital, over 80% of patients admitted are now suffering from infections caused by antibiotic-resistant microbes.Ironically, many of these infections originate in medical facilities, where hygiene protocols may be overwhelmed by the sheer volume of patients. In response to the escalating war, the Mechnikov Hospital has seen its ICU capacity balloon from 16 to 50 beds, all while grappling with reduced staffing levels as many healthcare workers enlist or flee. "In surgical departments, one nurse often cares for 15-20 patients, making proper hygiene nearly impossible," Dr. Strokan cautioned.Moreover, wartime conditions lead to higher exposure for soldiers who often undergo treatment at multiple medical facilities, each harboring unique AMR strains. For Pte Bezverkhny, who moved between three hospitals before reaching Kyiv, this meant enduring sepsis five times as the resistant infections spread unchecked.In contrast to previous conflicts, such as the Afghanistan War, where patients were stabilized before being air-lifted to specialist care, the critical influx of casualties in Ukraine forces a different approach. Once stabilized, patients are transported to clinics across the city, which inevitably spreads bacteria further.Ukraine's overwhelmed hospitals often lack the resources to isolate patients, enabling multi-resistant bacteria to proliferate. Special reserve antibiotics are needed for treatment, but excessive use can hasten the development of further resistance. "We must act judiciously; saving one life shouldn't create an unsolvable problem for the future," Dr. Strokan explained.In Pte Bezverkhny's case, the medical team relied on expensive antibiotics sourced from foreign volunteers. After a grueling year of hospitalization and over 100 surgeries, he is now out of immediate danger, yet the growing threat of antimicrobial resistance looms larger than ever, presenting a daunting challenge for medical teams striving to save lives in the midst of war.
