Occurrence, resistance patterns, and management of carbapenemase-producing bacteria in war-wounded refugees from Ukraine
Fabian K. Berger, Georges P Schmartz, T. A. Fritz, Nils T. Veith, Farah Alhussein, Sophie Roth, Sophie Schneitler, Thomas Gilcher, Barbara C. Gärtner, Vakhtang Pirpilashvili, Tim Pohlemann, Andreas Keller, Jacqueline Rehner, Sören L. Becker
Abstract
We analyzed consecutive clinical cases of infections due to carbapenemase-producing gram-negative bacteria detected in war-wounded patients from Ukraine who were treated at one university medical center in southwest Germany between June and December 2022. The isolates of multiresistant gram-negative bacteria were subjected to a thorough microbiological characterization and whole genome sequencing (WGS). We identified five war-wounded Ukrainian patients who developed infections with New Delhi metallo-β-lactamase 1-positive Klebsiella pneumoniae. Two isolates also carried OXA-48 carbapenemases. The bacteria were resistant to novel antibiotics, such as ceftazidime/avibactam and cefiderocol. The used treatment strategies included combinations of ceftazidime/avibactam + aztreonam, colistin, or tigecycline. WGS suggested transmission during primary care in Ukraine. We conclude that there is an urgent need for thorough surveillance of multiresistant pathogens in patients from war zones.