Antibiotic resistance is spiking during wartime in Ukraine. Curbing trends may be crucial to saving lives across the globe.

By Claire Wolters | Fact-checked by Davi Sherman
Published December 8, 2023

Key Takeaways

  • Antibiotic resistance is a growing global threat to public health.

  • The problem is attributed to millions of deaths worldwide and is estimated to cause more deaths than malaria or HIV.

Hospitals in Ukraine are experiencing dangerous spikes in antibiotic resistance, according to a new report from the Centers for Disease Control and Prevention (CDC). The report, which looks at data from 2022, attributes rising numbers to “wartime spread,” and stresses the importance of providing emergency intervention despite the ongoing conflict.[]

Trends appear to be influenced by the increased “prevalence of traumatic wounds, and the war-related strain on health care facilities,” according to the CDC.

Practicing antibiotic stewardship, through which physicians and prescribers prescribe antibiotics sparingly and limit unnecessary use, can slow antibiotic resistance and stop more bugs from forming.

Most common strains

The number of drug-resistant bacteria has grown in recent years, which can largely be attributed to increasing antibiotic use. Between 2000 and 2015, global antibiotic use increased by 65%, at least 30% of which is unnecessary, according to the CDC. If trends continue, the agency predicts that numbers could climb 200% from 2015 to 2030. Now, in 2023, these trends haven’t turned around yet.[]

According to the CDC, more than 2.8 million antimicrobial-resistant (AMR) infections occur in the US each year. Globally, in 2019, AMR was associated with almost 5 million deaths in 2019, according to the CDC. Along with drug-resistant bacteria, AMR can include resistant fungi and viruses. Antibiotic resistance alone is estimated to cause more deaths than HIV or malaria and is recognized as a leading public health threat worldwide, according to the new CDC report.[][]

Drug-resistant bugs can evade treatments in various ways, including blocking the drug’s entry, producing enzymes that destroy the drug inside the body, and altering the drug’s target so that it is ineffective. Some drugs have adapted to resist multiple medications, while some that are only resistant to one or a few have the ability to pass on resistant properties to bugs outside of their family, thereby increasing the problem.[]

In 2016, David White, PhD, a microbiologist in the Food and Drug Administration’s Center for Veterinary Medicine, described the process of AMR as “‘bacterial sex,’” in which bacteria mate with one another to pass on genetic traits and in the process, spread resistance from one species to another.[]

Resistant bacteria what to look out for

The World Health Organization (WHO) tracks and ranks drug-resistant bacteria, categorizing bacteria as having “critical,” “high,” or “medium” antibiotic resistance.[] 

“Critical-tier” bacterial pathogens include:

  • Acinetobacter baumannii

  • Enterobacteriaceae

  • Klebsiella pneumonia

  • Escherichia coli

  • Enterobacter spp.

  • Serratia spp.

  • Proteus spp.

  • Providencia spp.

  • Morganella spp.

“High-tier” bacteria pathogens include:

  • Enterococcus faecium

  • Staphylococcus aureus

  • Helicobacter pylori

  • Campylobacter

  • Salmonella spp.

  • Neisseria gonorrhoeae

“Medium-tier” bacterial pathogens include:

  • Streptococcus pneumoniae

  • Haemophilus influenzae

  • Shigella spp.

Among other targets, these drug-resistant bacteria can impact treatments for sexually transmitted infections (STIs), staph infections, and urinary tract infections (UTIs).

Infants and neonates can be particularly vulnerable to the impacts of drug-resistant bacteria. One of the most common drug-resistant bacteria, ranked as critical by the WHO, is Klebsiella pneumoniae. K. pneumonia is the most common pathogen for neonatal sepsis, which can have a 10% to 12%—or higher—mortality rate in babies.[]

Global threat

AMR is a global threat, but dangers are highest in low- and middle-income countries. Risks can easily spread across countries and continents through travel and can lurk in healthcare facilities, communities, food supplies, and the environment, according to the CDC.[]

Unsanitary environments and shortages of other treatments, including vaccines, in low- and middle-income countries increase people’s need for antibiotics, making over-prescribing hard to avoid in some places. As such, agencies like the CDC encourage antibiotic use when necessary but warn against divvying up unneeded prescriptions.[]

To stop more AMR pathogens from forming, the CDC stresses improving infection control, resistance detection, hygiene systems, and health education worldwide. Increasing access to clean environments, vaccines, and other lifesaving healthcare interventions, is imperative.

What this means for you

Antibiotic resistance is a growing threat to public health, particularly in low- and middle-income countries. A new CDC report shows spikes in antibiotic resistance during wartime in Ukraine.

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