Pandrug-Resistant Hypervirulent Klebsiella Bacteria Strains Emerging in Ukraine Hospitals
Nikhil Prasad Fact checked by:Thailand Medical News Team Nov 26, 2024 3 hours, 45 minutes ago
Medical News: A New Health Threat Amid War
Scientists from leading institutions across Europe and Ukraine have identified a grave public health challenge linked to the ongoing conflict in Ukraine. Research has revealed the emergence of pandrug-resistant (PDR) strains of Klebsiella pneumoniae, a highly virulent bacterium, in hospitals treating war-wounded patients. The alarming findings raise global concerns about antibiotic resistance and its interplay with war-torn healthcare infrastructures.
Pandrug-Resistant Hypervirulent Klebsiella Bacteria Strains Emerging in Ukraine Hospitals
The study, led by Professor Kristian Riesbeck from Lund University, Sweden, and involving researchers from Ukraine’s National Pirogov Memorial Medical University, MNPE Vinnytsia Regional Clinical Hospital, Bogomolets National Medical University, and Sweden’s Karolinska Institute, examined 37 clinical isolates of Klebsiella pneumoniae. The team discovered strains resistant to all antibiotics currently available. Not only are these bacteria untreatable with existing medicines, but they also exhibit heightened virulence, making infections significantly more severe.
Pandrug Resistance and Hypervirulence: A Double Threat
Klebsiella pneumoniae is known to cause a range of infections, including pneumonia, urinary tract infections, and sepsis. This
Medical News report explores the findings, which reveal that these bacteria are now both untreatable and hypervirulent, a combination rarely observed.
Genomic sequencing of the bacteria revealed the presence of numerous resistance and virulence genes. The PDR strains, particularly those resistant to colistin (an antibiotic of last resort), carried mutations in specific genes, such as pmrB and phoP, linked to antibiotic resistance. These bacteria also harbored genes like rmpA, rmpC, and iucA, which enhance their ability to cause severe infections.
Alarmingly, the researchers found that these strains could survive and thrive in conditions designed to mimic the human immune response. Experiments using mice and insect larvae demonstrated that the colistin-resistant bacteria caused significantly faster deaths compared to their susceptible counterparts. The findings suggest that these bacteria retain their ability to cause severe disease despite their resistance to antibiotics.
War’s Role in the Spread of Deadly Bacteria
The ongoing conflict in Ukraine has severely strained its healthcare system, creating a perfect storm for the proliferation of such pathogens. Overcrowded hospitals, limited infection control measures, and inadequate antibiotic stewardship have facilitated the spread of these bacteria. In war-torn areas, wounds and infections are common, and the limited availability of effective treatments only exacerbates the problem.
The study analyzed samples from 141 patients, including war-wounded adults and neonates with pneumonia. Approximately 6% of the bacteria from these patients exhibited resistance to all tested antib
iotics. Among these, the PDR Klebsiella pneumoniae strains were found to be the most dangerous.
The Genetic Basis of Resistance and Virulence
The researchers conducted whole-genome sequencing to identify the genetic basis of the bacteria's resistance and virulence. They found that:
-The strains carried carbapenemase genes, such as blaNDM-1 and blaOXA-48, which confer resistance to carbapenems, a class of powerful antibiotics.
-Mutations in genes like pmrB and phoP contributed to colistin resistance, a growing concern given colistin's status as a last-resort antibiotic.
-Virulence genes, including iucA (associated with siderophore production for iron acquisition) and rmpA (related to hypermucoviscosity), were prevalent in these strains.
The bacteria also displayed an ability to resist immune responses, particularly serum killing by the complement system, which is an essential part of the human immune defense.
Implications for Global Health
The findings are a stark reminder of the interconnectedness of global health. As these dangerous strains of Klebsiella pneumoniae continue to spread within Ukraine, there is a risk of international dissemination, especially as patients are transferred to other countries for treatment.
“Even though these pandrug-resistant bacteria are fighting to survive our antibiotic treatments, they still have a complete set of genes that make them capable of causing disease. This is surprising for us all and, unfortunately, a worrying sign for the future,” said Professor Riesbeck.
Addressing the Crisis
The study underscores the urgent need for coordinated international efforts to combat antibiotic resistance. Strategies should include:
-Strengthening infection prevention and control measures in hospitals, particularly in conflict zones.
-Promoting antibiotic stewardship to prevent the misuse and overuse of antibiotics.
-Investing in research to develop new antibiotics and alternative therapies.
-Enhancing global surveillance systems to track and respond to the spread of resistant bacteria.
The authors emphasize that without immediate intervention, these bacteria could become a significant global health crisis.
Conclusions
The emergence of pandrug-resistant and hypervirulent Klebsiella pneumoniae in Ukrainian hospitals is a grim reminder of the consequences of war on public health. These bacteria not only resist all available treatments but also retain their ability to cause severe and rapidly fatal infections. Their spread poses a significant threat not only to Ukraine but to global health.
The findings highlight the need for robust infection control measures, improved healthcare infrastructure, and international collaboration to address this growing challenge. The study serves as a wake-up call for the world to prioritize antimicrobial resistance as a critical public health issue.
The study findings were published in the peer-reviewed Journal of Infection.
https://www.journalofinfection.com/article/S0163-4453(24)00246-9/fulltext
For the latest on pandrug-resistant pathogens, news, keep on logging to Thailand
Medical News.
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