Using samples from 141 war casualties (133 adults injured during the war and eight newborns with pneumonia), it could be shown that several types of bacteria were resistant to broad-spectrum antibiotics and that 6% of all the samples were resistant to all antibiotics. the antibiotics that the researchers tested on them.

The researchers have now published a paper in Journal of Infection, in which they examine whether Klebsiella pneumoniae* has the ability to cause disease in a broader context. Klebsiella can cause urinary tract infections, pneumonia, wound skin infections, and sepsis. The researchers used samples from 37 of the patients who had previously been shown to have resistant bacteria. The entire genome of the bacteria was sequenced to examine whether there were genes that could cause resistance.

“All bacteria were shown to carry the genes that we know are associated with resistance. We saw that a quarter of them were resistant to all the antimicrobial drugs available on the market, these bacteria would have complete resistance ( pandrug-resistant). Infections caused by these bacteria are becoming very difficult, if not impossible, to treat with the drugs we have today,” explains Professor Riesbeck.

Pandroresistant bacteria are an extreme form of antibiotic resistance and a growing concern in healthcare.

The researchers wanted to know if the infection could spread further via bacteria collected from patients in Ukraine. To examine this, experiments were conducted on mice and insect larvae.

“It was shown that the types of bacteria most resistant to antibiotics were also the ones that survived best in mice with pneumonia. Likewise, these types of bacteria were so aggressive that they killed insect larvae a lot more quickly than bacteria less resistant to antibiotics.

Genetic sequencing showed that all of the fully resistant Klebsiella bacteria examined by the researchers carried the genes that make them more virulent.

“In many cases, bacteria lose their ability to infect and cause disease because all their energy is spent becoming resistant to antibiotics. But we may have underestimated bacteria: we have seen that many of these Types of bacteria originating from Ukraine are equipped with genes that make them both resistant and virulent,” explains Kristian Riesbeck.

According to Professor Riesbeck, this means that bacteria spreading among the injured in Ukraine will likely continue to survive and cause problems.

“This is something that will not go away over time. Until patients can be isolated and treated properly, the spread of infection will continue.”

Kristian Riesbeck calls the results frightening, but not unexpected. This is what happens when the infrastructure of a healthcare system collapses. And this applies to Ukraine and other war-torn regions around the world.

“Even though these pandora-resistant bacteria are fighting to survive our antibiotic treatments, they still have a full set of genes that make them capable of causing disease. This is surprising to all of us and unfortunately a worrying sign for the future.”

*Klebsiella pneumoniae is one of the leading bacterial causes of death worldwide. It is estimated that Klebsiella pneumoniae is responsible for approximately 20 percent of all deaths attributable to antimicrobial resistance.

The research was carried out with the support of, among others, the Knut and Alice Wallenberg Foundation, the Swedish Research Council, the Swedish Heart and Lung Foundation and ALF funding from the Skåne region.