Pandrug-Resistant Bacteria Emerging From the War in Ukraine are Highly Pathogenic

Kristian Riesbeck, a professor of clinical bacteriology at Lund University, was approached by Ukrainian microbiologist Oleksandr Nazarchuk for help in assessing antibiotic resistance in bacteria from severely injured, infected war patients. Using samples from 141 individuals, including 133 adults and 8 newborns with pneumonia, the study revealed widespread resistance to broad-spectrum antibiotics. Alarmingly, 6% of the samples were resistant to all antibiotics tested.

The findings, recently published in the Journal of Infection, focused on Klebsiella pneumoniae, a bacteria capable of causing urinary tract infections, pneumonia, wound infections, and sepsis. Researchers analyzed samples from 37 patients previously found to carry resistant strains. Whole-genome sequencing confirmed that all bacteria contained genes linked to antibiotic resistance. Notably, a quarter of these strains were completely resistant to available antimicrobial drugs (pandrug-resistant), making them nearly impossible to treat with current medicines.

To explore the bacteria’s potential for further spread, the team conducted experiments on mice and insect larvae. They discovered that the most antibiotic-resistant strains were also the most virulent, causing severe pneumonia in mice and rapidly killing insect larvae. Genetic analysis confirmed that these strains carried virulence genes in addition to resistance genes.

Ukrainian Strains Defy Expectations: Highly Resistant and Virulent

“Typically, bacteria lose their ability to cause disease as they become more resistant,” explains Professor Riesbeck. “But these strains from Ukraine defy that pattern, remaining both highly resistant and highly virulent.” He warns that these bacteria will likely continue to spread and cause severe infections as long as proper isolation and treatment are unavailable.

Riesbeck describes the results as alarming but unsurprising, highlighting the collapse of healthcare infrastructure in war zones like Ukraine. “This isn’t unique to Ukraine; similar issues arise in other conflict-affected areas. Pandrug-resistant bacteria remain equipped with genes that allow them to thrive and cause disease, posing a significant threat to global health.”

Klebsiella pneumoniae is a leading cause of bacterial mortality worldwide, responsible for an estimated 20% of deaths linked to antimicrobial resistance. The study received support from the Knut and Alice Wallenberg Foundation, Swedish Research Council, Swedish Heart Lung Foundation, and ALF funding from Region Skåne.

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