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. 2023 Jan;28(1):2200850.
doi: 10.2807/1560-7917.ES.2023.28.1.2200850.

Molecular surveillance of multidrug-resistant Gram-negative bacteria in Ukrainian patients, Germany, March to June 2022

Tilman Schultze  1   2   3 , Michael Hogardt  1   2   3 , Erwin Sanabria Velázquez  1   2   3 , Daniel Hack  1   2   3 , Silke Besier  1   2   3 , Thomas A Wichelhaus  1   2   3 , Ulrich Rochwalsky  4 , Volkhard Aj Kempf  1   2   3 , Claudia Reinheimer  1   2   3
Affiliations

Molecular surveillance of multidrug-resistant Gram-negative bacteria in Ukrainian patients, Germany, March to June 2022

Tilman Schultze et al. Euro Surveill. 2023 Jan.

Abstract

BackgroundSince the beginning of the war in Ukraine in February 2022, Ukrainians have been seeking shelter in other European countries.AimWe aimed to investigate the prevalence and the molecular epidemiology of multidrug-resistant Gram-negative (MDRGN) bacteria and meticillin-resistant Staphylococcus aureus (MRSA) in Ukrainian patients at admittance to the University Hospital Frankfurt, Germany.MethodsWe performed screening and observational analysis of all patients from March until June 2022. Genomes of MDRGN isolates were analysed for antimicrobial resistance, virulence genes and phylogenetic relatedness.ResultsWe included 103 patients (median age: 39 ± 23.7 years), 57 of whom were female (55.3%; 95% confidence interval (CI): 45.2-5.1). Patients were most frequently admitted to the Department of Paediatrics (29/103; 28.2%; 95% CI: 19.7-37.9). We found 34 MDRGN isolates in 17 of 103 patients (16.5%; 95% CI: 9.9-25.1). Ten patients carried 21 carbapenem-resistant (CR) bacteria, five of them more than one CR isolate. Four of six patients with war-related injuries carried eight CR isolates. In six of 10 patients, CR isolates caused infections. Genomic characterisation revealed that the CR isolates harboured at least one carbapenemase gene, bla NDM-1 being the most frequent (n = 10). Core genome and plasmid analysis revealed no epidemiological connection between most of these isolates. Hypervirulence marker genes were found in five of six Klebsiella pneumoniae CR isolates. No MRSA was found.ConclusionHospitals should consider infection control strategies to cover the elevated prevalence of MDRGN bacteria in Ukrainian patients with war-related injuries and/or hospital pre-treatment and to prevent the spread of hypervirulent CR isolates.

Keywords: Ukraine; molecular surveillance; refugees, multidrug-resistant gram-negative bacteria.

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Conflict of interest statement

Conflict of interest: TS, MH, EVS, DH, SB, TAW, UR, VAJK, CR are members of the University Centre of Competence for Infection Control of the State of Hesse, Frankfurt Main, Germany. VAJK is supported by the LOEWE-centre “ACLF-I, project P5”, of the State of Hesse, Germany. VAJK is member of the Commission for Hospital Hygiene and Infection Prevention, Robert Koch-Institute, Berlin, Germany.

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