Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct 25;3(1):153.
doi: 10.1038/s43856-023-00386-7.

The contribution of human conflict to the development of antimicrobial resistance

Scott J C Pallett  1 , Sara E Boyd  2 , Matthew K O'Shea  3 , Jessica Martin  4 , David R Jenkins  5 , Emma J Hutley  3
Affiliations

The contribution of human conflict to the development of antimicrobial resistance

Scott J C Pallett et al. Commun Med (Lond). .

Abstract

Human conflict, such as the ongoing conflict in Ukraine, is an important driver of antimicrobial resistance. Here, we describe the challenges when addressing this problem during an ongoing conflict and the opportunities available to reduce the spread of antimicrobial resistance.

PubMed Disclaimer

Conflict of interest statement

The authors declare the following competing interests: S.E.B. holds the Young Scientist Seat for the British Society for Antimicrobial Chemotherapy Antimicrobial Susceptibility Testing Committee. S.E.B. has consulted for bioMerieux and Sumitovant, received speaker fees from Shionogi and the UK Clinical Pharmacy Association, and was supported by a research grant obtained through a Medical Research Council (MRC)-awarded UK Research and Innovation Fellowship within the North West England MRC Scheme in Clinical Pharmacology with support from Roche Pharma (2017–21). D.R.J. is the President of the British Society for Antimicrobial Chemotherapy. E.J.H. is the Defence Consultant Advisor for UK Defence Medical Services Pathology. S.J.C.P. has received a research grant from the Scientific Exploration Society. All other authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1. Map showing movement of forcibly displaced peoples during conflicts in Ukraine, Afghanistan and Syria as of 2022 and the associated antimicrobial resistance pressures.
The coloured arrows show people predominantly moved to neighbouring countries. Of those displaced from their country of origin and in need of international protection, over half originated from conflicts associated with these three countries. Example 1 (red; Ukraine), the proportion of AMR microbes isolated from patients with infections of war-related injuries increased considerably in 2022 compared to 2021. Data was obtained from nationally collected surveillance data (2021; https://apps.who.int/iris/rest/bitstreams/1496762/retrieve; accessed 07 July 2023) and EUCAST supported sentinel susceptibility testing (2022) in the context of eruption of major widespread conflict in March 2022 Example 2 (green, Syrian Arab Republic) highlights that availability of antibiotics decreased during the conflict which led to a critical shortage and loss of drug supply security,. Example 3 (blue; Afghanistan) highlights molecular typing research that showed potential chains of transmission of AMR spread to the destination countries. Panels on the right demonstrate the top 10 destination locations for displaced populations for each example, with the number who moved stated and the proportion received by destination countries in the bar chart.
See this image and copyright information in PMC

References

    1. Pennington H. The impact of infectious disease in war time: a look back at WW1. Future Microbiol. 2019;14:165–168. doi: 10.2217/fmb-2018-0323. - DOI - PubMed
    1. World Health Organisation. Global action plan on antimicrobial resistance. 2015. https://apps.who.int/iris/rest/bitstreams/864486/retrieve (2015).
    1. UK Health Security Agency. Framework of actions to contain carbapenemase-producing Enterobacterales. https://assets.publishing.service.gov.uk/government/uploads/system/uploa... (2022).
    1. Bokhary H, Pangesti KNA, Rashid H, Abd El Ghany M, Hill-Cawthorne GA. Travel-related antimicrobial resistance: a systematic review. Trop Med. Infect. Dis. 2021;6:11. doi: 10.3390/tropicalmed6010011. - DOI - PMC - PubMed
    1. United Nations High Commissioner for Refugees. Figures at a glance: 108.4 million people worldwide were forcibly displaced. https://www.unhcr.org/about-unhcr/who-we-are/figures-glance (2023).