When Private Oleksander Bezverkhny was rushed to Kyiv’s Feofaniya Hospital, few believed he would survive. The 27-year-old soldier suffered severe injuries: a catastrophic abdominal wound, shrapnel damage to his buttocks, and the loss of both legs.
Compounding his already critical condition, doctors discovered his infections were resistant to commonly used antibiotics. Saving his life seemed an almost impossible task.
Antimicrobial Resistance (AMR) occurs when bacteria evolve to withstand the effects of antibiotics and other treatments, rendering these medicines ineffective. This global health crisis claimed approximately 1.4 million lives in 2021 alone. In the UK, over 66,000 serious antibiotic-resistant infections were recorded in 2023. Ukraine, however, faces a uniquely severe challenge, as the ongoing war accelerates the spread of multi-resistant pathogens.
Hospitals treating war casualties in Ukraine have reported a dramatic rise in AMR cases. At Feofaniya Hospital, more than 80% of patients suffer from infections caused by antibiotic-resistant microbes, according to Deputy Chief Physician Dr. Andriy Strokan.
Ironically, medical facilities often become the origin point for these infections. Despite efforts to maintain strict hygiene and use protective equipment, the sheer number of wounded overwhelms hospital resources.
At Dnipro’s Mechnikov Hospital, the intensive care unit expanded its capacity from 16 to 50 beds since the Russian invasion began, according to ICU Head Dr. Volodymyr Dubyna. Staffing shortages compound the problem, as many healthcare workers have either fled the conflict or joined the military.
Dr. Strokan highlighted the strain on surgical departments, noting that one nurse is often responsible for 15–20 patients. “It’s physically impossible for her to follow the required handwashing protocols to prevent infections from spreading,” he said.
The war also exposes patients to a wider variety of pathogens than in peacetime. Soldiers often pass through multiple medical facilities during evacuation, each carrying distinct strains of AMR bacteria. While unavoidable due to the scale of the conflict, this process exacerbates the spread of resistant infections.
Pte Bezverkhny’s journey illustrates this challenge. Treated at three separate facilities before arriving in Kyiv, his infections worsened with each transfer. Unable to respond to standard treatments, his condition deteriorated, and he developed sepsis five times.
The situation in Ukraine differs starkly from conflicts like the Afghanistan War, where Western soldiers were stabilized at the battlefield and swiftly transported to European clinics. In Ukraine, the scale of casualties hasn’t been seen since World War II, making such a streamlined system impossible.
As Dr. Dubyna explained, hospitals near the front lines, like his in Dnipro, must transfer stable patients to other facilities to accommodate the continuous influx of the severely wounded. Unfortunately, these transfers increase exposure to antibiotic-resistant bacteria, further complicating treatment and recovery efforts.
Ukraine’s healthcare system faces an uphill battle—not just against war-related injuries but also against the silent, pervasive threat of AMR, which continues to claim lives amidst the chaos of conflict.
“In terms of microbiological control, it means they spread [bacteria] further. But if it’s not done, we’re not able to work. Then it’s a catastrophe.”
With the overwhelming number of injured individuals, Ukrainian hospitals often lack the capacity to isolate patients with infections. This inability to isolate leads to the unchecked spread of dangerous, multi-resistant bacteria.
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To combat these infections, medical professionals must rely on specialized antibiotics from the “reserve” list. However, frequent use of these last-resort medications accelerates bacterial adaptation, rendering these critical drugs ineffective over time.
“We have to balance our scales,” Dr Strokan explains. “On the one hand, we must save a patient. On the other – we mustn’t breed new microorganisms that will have antimicrobial resistance.”
In Private Bezverkhny’s case, doctors had to rely on costly antibiotics, sourced by volunteers from abroad, to combat his resistant infections. After spending a year in the hospital and undergoing more than 100 surgeries, his condition is no longer life-threatening.
While his life was saved, the growing resistance of pathogens makes it increasingly challenging to secure similar outcomes for others in the future.
