Doctors didn’t think Private Oleksander Bezverkhny would live when he was taken to Kiev’s Feofaniya Hospital. During the ensuing fight, the 27-year-old soldier sustained devastating injuries, including shrapnel tearing through his buttocks and significant abdominal injury. Unfortunately, he had to have both of his legs amputated.
But Bezverkhny’s life was in danger not just because of his severe wounds but also because it was found that his illnesses were resistant to ordinary treatments. Antimicrobial resistance (AMR), a developing problem that has made treating certain infections more challenging, is the cause of this illness. After that, medical personnel rushed to save his life against nearly overwhelming odds in a fight against time.
What Is Antimicrobial Resistance's Increasing Danger?
Antibiotics and other medications become ineffective when bacteria develop defense mechanisms against them, a phenomenon known as antimicrobial resistance (AMR). Once-treatable infections have grown far more hazardous, and the situation in war-torn Ukraine is about to become out of hand.
According to a deputy head physician at Feofaniya Hospital, “one of the most important health issues of our time is antibiotic resistance.” “The difficulty is not just treating these infections, but managing them without making the problem worse by overusing antibiotics.”
Around 1.4 million fatalities worldwide are attributed to AMR each year, and in 2023, 66,730 severe antibiotic-resistant illnesses were reported in the UK alone. However, the destruction caused by the war in Ukraine has made matters worse, with hospitals and medical personnel being overrun by a rise in multi-resistant infections.
What Effects Does War Have on Healthcare Systems?
Many hospitals in Ukraine are reporting a substantial increase in AMR cases as they deal with an inflow of war-related injuries. The deputy chief physician at Feofaniya Hospital claims that more than 80% of the hospital’s admitted patients have diseases brought on by bacteria that are resistant to antibiotics.
“Medical institutions are under tremendous strain during times of war. The deputy head physician claims that the situation is ideal for the spread of illnesses and that they are overburdened with casualties. “Ironically, these infections often originate from the very medical facilities where patients are supposed to be receiving treatment.”
Staff members must put in endless effort to stop the spread of illnesses in these terrible conditions. Even while protective gear and hygienic practices are required, they are sometimes insufficient when hospitals are overcrowded.
Is There Enough Staff and Resources to Manage the Crisis?
“Since the Russian invasion began, our unit has expanded from 16 to 50 beds,” says the chief of the intensive care unit at Mechnikov Hospital in Dnipro, describing the difficulties experienced by medical personnel in the area. However, because so many of our healthcare professionals have either enlisted in the military or fled, staffing has dropped.
The infection control issue is made worse by these staffing shortages. The nurse-to-patient ratio in surgical departments can reach 1:20. Because of this, medical personnel find it extremely difficult to adhere to the stringent cleanliness protocols required to stop the spread of harmful microorganisms.
The ICU’s head claims that there is just not enough staff to meet the strict cleaning and sanitization standards. “One nurse cannot physically wash her hands often enough to guarantee that there is no chance of infection spreading.”
How Do More Resistant Strains Affect Soldiers?
Soldiers are regularly moved between medical institutions during times of conflict, which exposes them to an even greater variety of bacterial strains. The sheer volume of injuries makes this logistically necessary, but it also greatly accelerates the development of illnesses with antibiotic resistance.
An obvious illustration of this issue was the case of Pte Bezverkhny. He developed a number of resistant illnesses after receiving care at three separate institutions, which made his recuperation more difficult. His condition deteriorated despite the initial treatment, and he experienced sepsis five times.
“Compared to other recent conflicts, this is a different situation,” the ICU’s head said. “Western soldiers would frequently be evacuated to European hospitals for additional care after being stabilized on the ground in locations like Afghanistan. However, due to the severity of the injuries, patients in Ukraine frequently have to transfer between several nearby hospitals, each of which has its own distinct strains of resistant bacteria.
What Risks Come with Excessive Use of Reserve Antibiotics?
Hospitals in Ukraine are increasingly using antibiotics from the “reserve” list, a set of drugs used exclusively in the most severe situations, as the antimicrobial resistance crisis worsens. These medications are frequently costly and difficult to get, particularly in conflict areas. In order to help treat patients like Pte Bezverkhny, whose diseases were unmanageable with conventional therapy, volunteers have started obtaining these medications from overseas.
But physicians face a challenging situation. When reserve medicines are used excessively, the bacteria may become even more adaptive, making these life-saving drugs useless.
The deputy chief physician states, “We have to weigh the risk of creating new, resistant microorganisms against the need to save lives.” “The stakes are very high, and it’s a difficult decision.”
This delicate balancing act was essential to Bezverkhny. His life was no longer in imminent danger after more than 100 surgeries and more than a year in the hospital before the physicians were able to stabilize his condition. However, his fight against infections is far from finished because treating infections with antibiotic resistance is becoming more and more difficult for the medical community.
Why Does Addressing AMR Require Immediate Action?
The crisis in Ukraine emphasizes how urgent it is to address antibiotic resistance globally. Doctors are finding it more and more difficult to stop the spread of resistant bacteria in hospitals that are overburdened with combat injuries and lack resources. However, the answer is not straightforward; it calls for enhanced infection control protocols, global collaboration, and a sustained dedication to the development of novel antibiotics.
According to the deputy chief physician, “we can save lives, but the struggle is only getting harder.” “The risk of resistance increases daily, and the situation will only get worse if nothing is done quickly.”
As antimicrobial resistance continues to evolve and spread, the efforts of Ukraine’s medical professionals to save lives will become even more critical, but also more difficult.
