War-zone hospital patients found to carry multidrug-resistant bacteria

After Russia’s full-scale invasion, thousands of patients have been transferred from Ukraine to other European countries. A study by the University of Helsinki and HUS Helsinki University Hospital showed that 8% of Ukrainian refugees had been hospitalized due to war injuries. Almost 80% of them carried multidrug resistant (MDR) bacteria.

The study found that non-hospitalized refugees carried no more multidrug-resistant bacteria than previously shown for Finns who had traveled to Asia, Africa or South America.

“Concerns about the risk of antimicrobial resistance relate specifically to patients who have been hospitalized in conflict-affected areas. Patients with war injuries were found to carry highly resistant bacteria, which often caused serious infections,” says Professor Anu Kantele of the University of Helsinki, who led the study.

The findings are published in the journal Clinical Microbiology and Infection.

Multidrug-resistant bacteria spread across borders

Health care systems in war zones are particularly vulnerable to the spread of multidrug-resistant bacteria.

“Hospitals in such areas are overburdened, and effective infection prevention is impossible. These conditions facilitate the spread of difficult-to-treat bacteria,” notes Kantele.

Ukrainian refugees who had not been hospitalized abroad before arriving in Finland were clearly less likely to carry multidrug-resistant bacteria. They were found to carry mainly ESBL-producing E. coli bacteria and, in individual patients, MRSA bacteria.

“Ordinary citizens need not worry. The problem relates specifically to hospital settings,” emphasizes Doctoral Researcher Tuomas Aro, who specializes in infectious diseases.

The Finnish health care system is prepared to tackle the challenge. At Finnish hospitals, patients previously hospitalized abroad are placed in single rooms, with contact isolation measures in place and bacterial samples taken.

“It’s important to understand that the prevalence of antimicrobial resistance is no more common among ordinary refugees than among Finns after a trip to Asia, for instance,” says Kantele.