Microbiological profile and antimicrobial resistance of mine-blast wounds in Ukraine: a single-center study
DOI:
https://doi.org/10.14739/2310-1210.2025.5.338900Keywords:
blast injuries, wounds, blast-related injuries, wound, antimicrobial resistance, Acinetobacter baumannii, Klebsiella pneumoniaeAbstract
Infections resulting from combat wounds pose a significant challenge to modern medicine. Their unique polymicrobial nature, combined with massive tissue damage and the presence of foreign bodies, creates a favorable environment for the development of multidrug-resistant pathogens. The increasingly high level of antimicrobial resistance in the context of combat operations in Ukraine underscores the critical need for continuous epidemiological surveillance and adaptation of clinical protocols.
The aim of this study was to determine the species composition and antimicrobial resistance profile of causative agents of suppurative-inflammatory soft tissue diseases in patients with blast-related trauma who were treated at a tertiary medical facility.
Materials and methods. A prospective, single-center, observational study was conducted from January to May 2025 at the Kyiv Regional Clinical Hospital. A total of 276 wound samples were analyzed. The identification of microorganisms and testing of antibiotic sensitivity were performed according to the EUCAST methods and interpretation.
Results. Of the 276 samples, 86.6 % were positive. A total of 171 clinical strains were isolated, of which 58.5 % were Gram-negative and 38.2 % were Gram-positive microorganisms, and 2.3 % were fungi. The dominant etiological agent was Acinetobacter baumannii (21.6 %), followed by Klebsiella pneumoniae (13.5 %) and Proteus mirabilis (7.0 %). In A. baumannii, extremely high levels of resistance to carbapenems (imipenem – 83.8 %, meropenem – 73.0 %) and fluoroquinolones (94.6 %) were observed, while high sensitivity to colistin (100.0 %) and tobramycin (73.0 %) was maintained.
Conclusions. The local results obtained confirm the nationwide trend of the dominance of multidrug-resistant Gram-negative pathogens in combat wound infections. The detected high level of resistance to broad-spectrum drugs indicates a critical need for the optimization of empirical antibiotic therapy and the strengthening of infection prevention and control measures.
References
Sahli ZT, Bizri AR, Abu-Sittah GS. Microbiology and risk factors associated with war-related wound infections in the Middle East. Epidemiol Infect. 2016;144(13):2848-57. doi: https://doi.org/10.1017/S0950268816000431
Rodero Roldán M, Yuste Benavente V, Martínez Álvarez RM, López Calleja AI, García-Lechuz JM. Characterization of wound infections among patients injured during the Ruso-Ukrainian war in a Role 4 hospital. Enferm Infecc Microbiol Clin (Engl Ed). 2024;42(9):501-6. doi: https://doi.org/10.1016/j.eimce.2024.06.002
Pallett SJ, Morkowska A, Woolley SD, Potochilova VV, Rudnieva KL, Iungin OS, et al. Evolving antimicrobial resistance of extensively drug-resistant Gram-negative severe infections associated with conflict wounds in Ukraine: an observational study. Lancet Reg Health Eur. 2025;52:101274. doi: https://doi.org/10.1016/j.lanepe.2025.101274
Mc Gann PT, Lebreton F, Jones BT, Dao HD, Martin MJ, Nelson MJ, et al. Six Extensively Drug-Resistant Bacteria in an Injured Soldier, Ukraine. Emerg Infect Dis. 2023;29(8):1692-5. doi: https://doi.org/10.3201/eid2908.230567
Muresu N, Deiana G, Dettori M, Palmieri A, Masia MD, Cossu A, et al. Infection Prevention Control Strategies of New Delhi Metallo-β-lactamase Producing Klebsiella pneumoniae. Healthcare (Basel). 2023;11(18):2592. doi: https://doi.org/10.3390/healthcare11182592
Kryzhevskyi V, Strokous V, Lifshyts Y, Rybianets Y, Oberniak A, Krikunov A, et al. Case report: Azithromycin-meropenem combination therapy as a low-cost approach to combat PDR gram-negative infections of war wounds in Ukraine. Front Med (Lausanne). 2023;10:1264492. doi: https://doi.org/10.3389/fmed.2023.1264492
Ljungquist O, Nazarchuk O, Kahlmeter G, Andrews V, Koithan T, Wasserstrom L, et al. Highly multidrug-resistant Gram-negative bacterial infections in war victims in Ukraine, 2022. Lancet Infect Dis. 2023;23(7):784-6. doi: https://doi.org/10.1016/S1473-3099(23)00291-8
Ljungquist O, Magda M, Giske CG, Tellapragada C, Nazarchuk O, Dmytriiev D, et al. Pandrug-resistant Klebsiella pneumoniae isolated from Ukrainian war victims are hypervirulent. J Infect. 2024;89(6):106312. doi: https://doi.org/10.1016/j.jinf.2024.106312
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Copyright (c) 2025 H. V. Filonenko, Yu. V. Shypovych, D. O. Dziuba, N. I. Andrusyshyn, M. A. Bas-Yurchyshyn, I. R. Tymechko, Yu. T. Konechnyi
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