. Scientific Frontline: More multi-resistant germs since the beginning of the Ukraine war

Thursday, February 2, 2023

More multi-resistant germs since the beginning of the Ukraine war

Martina Cremadus, Hans-Jörg Berthold and Niels Pfennigwerth (from left) monitor the occurrence of multi-resistant bacteria in the National Reference Center for Gram-negative Hospital Pathogens.
Photo Credit: RUB, Marquard

The pathogens reach German hospitals with refugees and war injuries. Researchers recommend clinics to screen as a precaution.

Since the outbreak of the war in Ukraine, certain hospital pathogens that are resistant to many antibiotics have been detected much more frequently in German hospitals. The pathogen Klebsiella pneumoniae is also resistant to the reserve antibiotics of carbapenems due to a combination of two enzymes. Together with the Robert Koch Institute (RKI), the National Reference Center (NRZ) for gram-negative hospital pathogens located at the Ruhr University Bochum has been able to demonstrate that many of the reported cases are related to patients from Ukraine. The researchers therefore recommend that this group be examined for the germ before being admitted to the hospital. They report in the journal Eurosurveillance.

A striking connection can be demonstrated

The affected isolates of the bacterium Klebsiella pneumoniae, which have been proven to be increasing in samples from German clinics since spring 2022, produce a combination of two different so-called carbapenemases that are able to split the reserve antibiotics: NDM-1 and OXA-48. "We noticed that many of the samples concerned were related to Ukraine, that the corresponding patients had fled there, for example, or were hospitalized as war injuries in Germany," explains Dr. Niels Pfennigwerth from the NRZ. Further studies have shown that there is actually a connection that was also reflected in the registration numbers of the Robert Koch Institute.

"Our analyzes have shown that as a result of the hospitalization of Ukrainian patients, there has very likely already been an outbreak in Germany with these bacterial strains," said Niels Pfennigwerth. The team from NRZ and RKI therefore recommend a preventive screening of people related to Ukraine when admitted to German hospitals. "If it is confirmed that the person is populated with the pathogen, they will be isolated in the hospital and very strict hygiene measures will be taken," said the researcher.

Otherwise, healthy people often notice nothing of the settlement with such germs. In the hospital, however, the pathogens can be transferred primarily to people who are severely damaged due to illnesses or injuries, especially through the hands of the staff. In this case Klebsiella pneumoniae triggers, among other things, pneumonia, wound infections or urinary tract infections. In the worst case, treatment is no longer possible due to the resistance even to reserve antibiotics, which are reserved exclusively for severe cases that have to be treated in the hospital.

National reference center for gram-negative hospital pathogens

Since 2009, the National Reference Center (NRZ) for gram-negative hospital pathogens in the Department of Medical Microbiology at the Ruhr University in Bochum has been collecting data across Germany about bacteria that are resistant to various antibiotics - one speaks of multi-resistance. The center works closely with the Robert Koch Institute and monitors the presence of these bacteria as a body commissioned by the RKI.

Published in journalEurosurveillance

Source/CreditRuhr University Bochum

Reference Number: mcb020223_01

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