Мікробіологічний профіль та антимікробна резистентність мінно-вибухових ран в Україні: одноцентрове дослідження

Infections resulting from combat wounds pose a significant challenge to modern medicine. Their unique polymicrobial nature, combined with massive tissue damage and the presence of foreign bodies, creates a favorable environment for the development of multidrug-resistant pathogens. The increasingly high level of antimicrobial resistance in the context of combat operations in Ukraine underscores the critical need for continuous epidemiological surveillance and adaptation of clinical protocols. The aim of this study was to determine the species composition and antimicrobial resistance profile of causative agents of suppurative-inflammatory soft tissue diseases in patients with blast-related trauma who were treated at a tertiary medical facility. Materials and methods. A prospective, single-center, observational study was conducted from January to May 2025 at the Kyiv Regional Clinical Hospital. A total of 276 wound samples were analyzed. The identification of microorganisms and testing of antibiotic sensitivity were performed according to the EUCAST methods and interpretation. Results. Of the 276 samples, 86.6 % were positive. A total of 171 clinical strains were isolated, of which 58.5 % were Gram-negative and 38.2 % were Gram-positive microorganisms, and 2.3 % were fungi. The dominant etiological agent was Acinetobacter baumannii (21.6 %), followed by Klebsiella pneumoniae (13.5 %) and Proteus mirabilis (7.0 %). In A. baumannii, extremely high levels of resistance to carbapenems (imipenem – 83.8 %, meropenem – 73.0 %) and fluoroquinolones (94.6 %) were observed, while high sensitivity to colistin (100.0 %) and tobramycin (73.0 %) was maintained. Conclusions. The local results obtained confirm the nationwide trend of the dominance of multidrug-resistant Gram-negative pathogens in combat wound infections. The detected high level of resistance to broad-spectrum drugs indicates a critical need for the optimization of empirical antibiotic therapy and the strengthening of infection prevention and control measures.