%0 Journal Article
%T Temporal evolution of bacterial species and their antimicrobial resistance characteristics in wound infections of war-related injuries in Ukraine from 2014 to 2023.
%A Kovalchuk V
%A Kondratiuk V
%A Gann PM
%A Jones BT
%A Fomina N
%A Nazarchuk O
%A Fomin O
%A Kovalenko I
%J J Hosp Infect
%V 0
%N 0
%D 2024 Jul 10
%M 38997008
%F 8.944
%R 10.1016/j.jhin.2024.06.011
%X 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.