Kyiv, Jan 22: Hospitals in Ukraine are grappling with a sharp increase in antimicrobial resistance (AMR) among patients, a crisis exacerbated by the ongoing war. At Kyiv’s Feofaniya Hospital, over 80% of patients suffer from infections resistant to common antibiotics, according to deputy chief physician Dr. Andriy Strokan. The alarming rise in AMR poses a significant challenge to war-time healthcare.
The war has created ideal conditions for the rapid spread of multi-resistant pathogens. Patients often pass through multiple facilities before receiving advanced care, exposing them to various strains of bacteria.
“In surgical departments, there is one nurse that looks after 15-20 patients. She physically cannot scrub up her hands in the required amount and frequency in order not to spread infections,” said Dr. Strokan, while talking to BBC.
Unlike previous conflicts, such as the Afghanistan War where soldiers were stabilized and flown directly to specialized facilities, Ukraine’s overwhelmed clinics cannot adopt such measures due to the unprecedented influx of casualties.
The strain on Ukrainian healthcare facilities is immense. At Mechnikov Hospital in Dnipro, ICU beds have increased from 16 to 50 since the invasion began. However, staffing shortages—as many medical workers have fled or joined the military—further complicate infection control.
“In terms of microbiological control, it means they spread [bacteria] further. But if it’s not done, we’re not able to work. Then it’s a catastrophe,” said Dr. Volodymyr Dubyna, head of the ICU at Mechnikov Hospital.
Patients with drug-resistant infections require specialized antibiotics from the “reserve” list. However, frequent use of these powerful drugs risks further bacterial adaptation, potentially rendering them ineffective in the future.
“We must save a patient. On the other – we mustn’t breed new microorganisms that will have antimicrobial resistance,” said Dr. Strokan. The cost of these antibiotics is another hurdle, often requiring international aid or donations to secure.
Private Oleksander Bezverkhny, 27, suffered a severe abdominal injury and lost both legs in an explosion. Transferred through three medical facilities, he contracted multiple resistant infections, including sepsis five times. After more than 100 operations and a year in hospital, he was stabilized with the help of costly antibiotics sourced by volunteers.
“Doctors managed to save his life. But as pathogens grow more resistant, the struggle to save others only gets harder,” said Strokan.
Globally, AMR infections claimed 1.4 million lives in 2021, with 66,730 serious cases reported in the UK in 2023. However, the scale of the crisis in Ukraine—comparable to World War Two—has created a uniquely challenging environment for healthcare workers.
Without adequate containment measures and resources, experts warn the AMR crisis will escalate, threatening the survival of countless patients and undermining global efforts to combat antibiotic resistance.
