BBCWhen Pte Oleksander Bezverkhny was discharged from Feofaniya Hospital in Kyiv, few believed he would survive. The 27-year-old suspect was seriously wounded in the stomach and the explosives had torn his buttocks. Both of his legs were amputated.
Then, doctors discovered that his infections were resistant to commonly used antibiotics – and the already difficult task of saving his life became almost hopeless.
Antimicrobial resistance (AMR) is when bacteria mutate and learn to resist antibiotics and other drugs, rendering them ineffective.
Ukraine is far from the only country affected by this issue: around 1.4 million people worldwide died from AMR infection in 2021, while in the UK there were 66,730 antibiotic-resistant infections in 2023. However, the war seems to have accelerated the spread of many resistant viruses in Ukraine.
Clinics treating war casualties have registered a significant increase in AMR cases. More than 80% of patients hospitalized in Feofaniya Hospital have infections caused by bacteria that cannot resist antibiotics, according to deputy doctor Andriy Strokan.
Ironically, antimicrobial-resistant infections often appear in medical facilities.
Medical workers try to follow strict hygiene rules and use protective equipment to reduce the spread of these diseases, but facilities can be overwhelmed by people injured in war.
Dr. Volodymyr Dubyna, the head of the ICU at Mechnikov Hospital, said that since the beginning of the Russian attack, his unit alone has increased the number of beds from 16 to 50. Meanwhile, as many workers flee the war or join the armed forces themselves, they have workers. low levels.
Dr. Strokan explained that these conditions can affect the spread of AMR viruses. “In the surgical departments, there is one nurse who takes care of 15-20 patients,” he said. “He can’t scrub his hands with the necessary amount and frequency so he doesn’t spread disease.”
The nature of this war also means that patients get more infections than they would in peacetime. When a soldier is discharged for medical reasons, they will often go through multiple facilities, each with their own types of AMR. While medical experts say this is inevitable due to the scale of the war, it is fueling the rise of AMR infections.
This was the case for Pte Bezverkhny who was treated in three different centers before arriving at the hospital in Kyiv. As his illnesses could not be treated with conventional medicine, his condition worsened and he contracted sepsis five times.
This situation is different from other recent conflicts, for example the War in Afghanistan, where Western troops would be stationed in the area and transferred by air to a European clinic rather than going through many different local facilities.
This would not happen in Ukraine as the influx of patients has not been seen since the Second World War, according to Dr. Dubyna, whose hospital is located in the neighboring Dnipro region. When his patients are strong enough, they are transferred to another clinic – if you have space – to relieve the dose.
“In terms of microbiological control, it means that they are spreading [bacteria] continuously. But if it is not done, we cannot work. Then it’s a disaster.”
With so many people injured, Ukraine’s hospitals are often unable to isolate infected patients – meaning the multi-resistant and deadly virus is spreading unchecked.
The problem is that the infections that cause them must be treated with special antibiotics from the “reserved” list. But when doctors say this, the bacteria quickly adapt, making those antibiotics ineffective.
“We have to balance our scales,” explained Dr. Strokan. “On the one hand, we have to save the patient. On the other hand – we shouldn’t breed new bacteria that will be resistant to the bacteria.”
In the case of Pte Bezverkhny, doctors had to use expensive antibiotics, volunteers from abroad. After a year in the hospital and over 100 surgeries, his condition is no longer life-threatening.
Doctors were able to save his life. But as viruses grow more resistant, the struggle to save others becomes more difficult.
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