PANDRUG-resistant Klebsiella pneumoniae strains isolated from Ukrainian war victims are raising red flags for healthcare professionals worldwide. These bacteria, resistant to nearly all antibiotics including colistin, were analyzed in a recent study, revealing their dangerous combination of hypervirulence and multidrug resistance.
Researchers tested 37 clinical isolates from war victims hospitalized in Ukraine. All were resistant to carbapenems and cephalosporins, with nine also resistant to colistin, an antibiotic of last resort. Whole-genome sequencing uncovered genes linked to both resistance and virulence. Key mutations in the pmrB and phoP genes were associated with colistin resistance, while virulence genes such as iucA and rmpA contributed to severe pathogenicity.
The colistin-resistant strains demonstrated alarming traits: higher survival in serum tests, greater lethality in insect models, and improved survival in mice. These findings suggest that these strains retain, or even enhance, their ability to cause severe disease despite extensive drug resistance.
This discovery underscores an urgent need for coordinated efforts to prevent the global spread of such superbugs. The unique combination of multidrug resistance and hypervirulence makes these bacteria a particularly dire threat, especially in settings where infection control is challenging.
Reference: Ljungquist O et al. Pandrug-resistant Klebsiella pneumoniae isolated from Ukrainian war victims are hypervirulent. J Infect. 2024;106312. (In press).
