Medical professionals in Ukraine have sounded the alarm over the deadly bacteria called Klebsiella pneumoniae. They consider this to be a “hyper-virulent” bacteria which is “pandrug resistant,” meaning that no single antibiotic can stop it. All combat zones around the world are breeding grounds for antimicrobial resistance (ARM), since bullets and shrapnel can deliver pathogens deep inside the body, but in Ukraine, the world’s strongest antibiotics are often having no effect. “It’s eye-opening just how incredibly resistant some of the bacteria coming out of Ukraine are. I haven’t seen anything like it,” says Jason Bennett, director of the Multidrug-Resistant Organism Repository and Surveillance Network at the Walter Reed Army Institute of Research (WRAIR), according to Science.org from the American Association for the Advancement of Science. Researchers have found that the resistant bacteria have an enzyme called NDM-1 which produces a mucus-type biofilm that can protect the bacteria. 80% of the Klebsiella microbe found in Ukraine carry NDM-1 enzyme—which is a rate 10 times higher than in the rest of Europe. Ukraine has a higher rate of ARM due in part to the decades of overuse of antibiotics, which can be purchased over the counter. There has also been a common practice of clinics in Ukraine prescribing small doses of antibiotics. This does not kill the targeted bacteria, but instead allows bacteria to adapt. The elevated rates of ARM in Ukraine started in 2014, when the fighting began in the Donbass region. Some 20% of hospital infections in Ukraine now involve resistant bacteria, and Klebsiella is the most common form.
In the U.S. a patient fighting a resistant infection can expect a private room for isolation and a dedicated care team, but in Ukraine, patients are overflowing into the hallways. Hospitals lack sufficient supplies of water and alcohol for sterilization, and suffer frequent power outages. One hospital in Ukraine, however, has successfully saved 50 patients by administering azithromycin and meropenem, which disrupts the biofilm protecting the bacteria, allowing antibiotics to take effect.
