Antibiotic resistance: the hidden danger on Ukraine’s frontlines

Multi-drug antibacterial resistance caused by the war in Ukraine is now “on the doorstep” of western Europe, according to an Australian clinician who has worked in the war-torn country.

Potentially lethal infections in Ukraine have increased 10-fold since the start of the war, Hailie Uren told Vaccines Work, and this “really frightening” level of antimicrobial resistance (AMR) there is on the march beyond its borders.

Invisible threat

Humans are “host” to over a thousand species of bacteria, including some superbugs that are “deemed critical threats”, said The New York Times. Normally, they don’t “become pathogenic in healthy people” but “war changes that”. War “deprives people of food, clean water and sanitary living conditions”, and “when bombs and bullets fly” wounds become “perforated with shrapnel, debris and soil teeming with microbes”. Even before the war, Ukraine had a high rate of antibiotic-resistant tuberculosis, which can spread even more easily in barracks, bomb shelters and refuge centres.

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A “rising number of wounded soldiers” in Ukraine are being infected with microbes that are “extensively drug-resistant” or which “withstand most or all antibiotics thrown at them”, said Vaccines Work. Doctors and scientists in Ukraine are waging a “shadow war” against this rising tide of “pernicious infections”, which have also “begun circulating in the general population”, including children.

The Lviv region, on the “doorstep” of the European Union, has “some of the highest multi-drug resistance levels” in all of Ukraine.

In Estonia, drug-resistant pathogens are already being “brought in” by Ukrainian refugees, said ERR News.

Pernicious threat

A “growing body of research” suggests that the “21st-century way of warfare has become a major driver” of AMR, particularly in the Middle East, said The New York Times. In Syria, “protracted” fighting has “exacerbated existing drivers of antimicrobial resistance and introduced new ones”, representing a “rising threat” to the country’s health system, according to a study published in Nature.

Before the Second World War and the “advent of antibiotics, infections routinely killed more soldiers than combat itself”, said the Financial Times. Today, AMR has become a “different and arguably more pernicious kind of threat” and one that “could continue to claim lives long after conflict is over”.

Last year, England’s former chief medical officer warned that the rise of superbugs that are resistant to antibiotics poses a greater threat to humanity than climate change. A paper published in The Lancet last September estimated that AMR could contribute to the deaths of 8.22 million people per year by 2050 – more than the number currently killed by cancer.