Abstract：
BACKGROUND: This study continues surveillance of antimicrobial resistance associated with combat injuries in Ukraine.
OBJECTIVE: To compare species composition, antibiotic resistance profiles, and emergence of new resistance genes between 2014-2020 and 2022-2023.
METHODS: Retrospective multicentre microbiological survey in Ukrainian hospitals. Antibiotic susceptibility, whole genome sequencing, and MLST typing were conducted on 154 organisms obtained from 125 casualties from 2022-2023.
RESULTS: The data reveals a predominance of gram-negative bacteria, particularly Acinetobacter baumannii (35.7%), Pseudomonas aeruginosa (14.9%), and Klebsiella pneumoniae (20.7%). High levels of carbapenem resistance was observed among A. baumannii (meropenem 72,2% [(39/54) 95% CI 58.4-83.5], imipenem 66.7% [(36/54) 95% CI 52.5-78.9]), Klebsiella (meropenem 90.6% [(29/32) 95% CI 75.0-98.0], imipenem 81.2% [(26/32) 95% CI 63.6-92.8]), and P. aeruginosa (meropenem 47.8% [(11/23) 95% CI 26.8-69.4], imipenem 60.8% [(14/23) 95% CI 38.5-80.3]) strains. A. baumannii ST-78 and ST-400 were prevalent from 2014 to 2020, while 5 strains of ST-1077 were newly identified. Pseudomonas aeruginosa strains showed diversity across 16 sequence types (STs), with ST-773 increasing in frequency and new STs emerging, but lacking carbapenemase genes. K. pneumoniae exhibited increased genetic diversity over time, with three STs from 2014 to 2020 and six new STs, including blaNDM-1, blaOXA-48, and blaKPC2 carriers, in recent years.
CONCLUSIONS: There is a growing prevalence of multidrug resistant isolates from globally distributed sequence types.
OBJECTIVE: To compare species composition, antibiotic resistance profiles, and emergence of new resistance genes between 2014-2020 and 2022-2023.
METHODS: Retrospective multicentre microbiological survey in Ukrainian hospitals. Antibiotic susceptibility, whole genome sequencing, and MLST typing were conducted on 154 organisms obtained from 125 casualties from 2022-2023.
RESULTS: The data reveals a predominance of gram-negative bacteria, particularly Acinetobacter baumannii (35.7%), Pseudomonas aeruginosa (14.9%), and Klebsiella pneumoniae (20.7%). High levels of carbapenem resistance was observed among A. baumannii (meropenem 72,2% [(39/54) 95% CI 58.4-83.5], imipenem 66.7% [(36/54) 95% CI 52.5-78.9]), Klebsiella (meropenem 90.6% [(29/32) 95% CI 75.0-98.0], imipenem 81.2% [(26/32) 95% CI 63.6-92.8]), and P. aeruginosa (meropenem 47.8% [(11/23) 95% CI 26.8-69.4], imipenem 60.8% [(14/23) 95% CI 38.5-80.3]) strains. A. baumannii ST-78 and ST-400 were prevalent from 2014 to 2020, while 5 strains of ST-1077 were newly identified. Pseudomonas aeruginosa strains showed diversity across 16 sequence types (STs), with ST-773 increasing in frequency and new STs emerging, but lacking carbapenemase genes. K. pneumoniae exhibited increased genetic diversity over time, with three STs from 2014 to 2020 and six new STs, including blaNDM-1, blaOXA-48, and blaKPC2 carriers, in recent years.
CONCLUSIONS: There is a growing prevalence of multidrug resistant isolates from globally distributed sequence types.
摘要：
背景：本研究继续监测与乌克兰战伤相关的抗菌素耐药性。
目的：比较物种组成，抗生素耐药性概况，以及2014-2020年和2022-2023年之间新的抗性基因的出现。
方法：乌克兰医院的回顾性多中心微生物调查。抗生素敏感性,全基因组测序，对2022-2023年从125名伤亡人员中获得的154种生物进行了MLST分型。
结果：数据显示革兰阴性菌占优势，特别是鲍曼不动杆菌（35.7%），铜绿假单胞菌(14.9%),肺炎克雷伯菌(20.7%)。在鲍曼不动杆菌中观察到高水平的碳青霉烯耐药性（美罗培南72,2％[（39/54）95％CI58.4-83.5]，亚胺培南66.7%[（36/54）95%CI52.5-78.9]），克雷伯菌（美罗培南90.6%[（29/32）95%CI75.0-98.0]，亚胺培南81.2%[（26/32）95%CI63.6-92.8]），和铜绿假单胞菌（美罗培南47.8%[（11/23）95%CI26.8-69.4]，亚胺培南60.8%[（14/23）95%CI38.5-80.3]）菌株。2014年至2020年鲍曼不动杆菌ST-78和ST-400流行，新发现5株ST-1077。铜绿假单胞菌菌株显示出跨越16种序列类型(STs)的多样性,随着ST-773频率的增加和新的ST的出现，但缺乏碳青霉烯酶基因.肺炎克雷伯菌随着时间的推移表现出增加的遗传多样性，从2014年到2020年有3个STS和6个新的STS，包括blaNDM-1、blaOXA-48和blaKPC2载波，近年来。
结论：来自全球分布的序列类型的多药耐药分离株的流行率越来越高。
目的：比较物种组成，抗生素耐药性概况，以及2014-2020年和2022-2023年之间新的抗性基因的出现。
方法：乌克兰医院的回顾性多中心微生物调查。抗生素敏感性,全基因组测序，对2022-2023年从125名伤亡人员中获得的154种生物进行了MLST分型。
结果：数据显示革兰阴性菌占优势，特别是鲍曼不动杆菌（35.7%），铜绿假单胞菌(14.9%),肺炎克雷伯菌(20.7%)。在鲍曼不动杆菌中观察到高水平的碳青霉烯耐药性（美罗培南72,2％[（39/54）95％CI58.4-83.5]，亚胺培南66.7%[（36/54）95%CI52.5-78.9]），克雷伯菌（美罗培南90.6%[（29/32）95%CI75.0-98.0]，亚胺培南81.2%[（26/32）95%CI63.6-92.8]），和铜绿假单胞菌（美罗培南47.8%[（11/23）95%CI26.8-69.4]，亚胺培南60.8%[（14/23）95%CI38.5-80.3]）菌株。2014年至2020年鲍曼不动杆菌ST-78和ST-400流行，新发现5株ST-1077。铜绿假单胞菌菌株显示出跨越16种序列类型(STs)的多样性,随着ST-773频率的增加和新的ST的出现，但缺乏碳青霉烯酶基因.肺炎克雷伯菌随着时间的推移表现出增加的遗传多样性，从2014年到2020年有3个STS和6个新的STS，包括blaNDM-1、blaOXA-48和blaKPC2载波，近年来。
结论：来自全球分布的序列类型的多药耐药分离株的流行率越来越高。
