{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:53:13Z","timestamp":1793386393581,"version":"4.5.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T00:00:00Z","timestamp":1687219200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T00:00:00Z","timestamp":1687219200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007653","name":"Universit\u00e4tsklinikum Jena","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007653","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Antimicrobial resistance is a pressing issue in Ukraine, with healthcare-associated infections caused by multidrug-resistant organisms being a major concern. A recent prospective multicenter study revealed a staggering rate of 48.4% antimicrobial resistance to carbapenems among Enterobacterales causing a healthcare-associated infection. We conducted a systematic survey to investigate the incidence rate and incidence density of carbapenemase-producing Gram-negative bacteria (CPGN) among refugees and war-wounded Ukrainians in connection with the German health system.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>From the onset of the war until November 2022, seven Ukrainian patients were admitted to our hospital. Upon admission, screening samples and samples from the focus of suspected infection were taken from all seven patients. The incidence rate and the incidence density of CPGN were calculated as a result of the microbiological findings. We sequenced all CPGN using Illumina technology.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The incidence rate of CPGN at our hospital was 0.06 for 2021 and 0.18 for 2022. All seven Ukrainian patients were infected or colonized with at least one CPGN, including <jats:italic>K. pneumoniae<\/jats:italic> (14\/25)<jats:italic>, P. aeruginosa<\/jats:italic> (6\/25), <jats:italic>A. baumannii<\/jats:italic> (1\/25), <jats:italic>Providencia stutartii<\/jats:italic> (1\/25), <jats:italic>C. freundii<\/jats:italic> (1\/25), and <jats:italic>E. coli<\/jats:italic> (2\/25)<jats:italic>.<\/jats:italic> Genomic surveillance revealed that (i) most frequently detected carbapenemases among all sequenced isolates were <jats:italic>bla<\/jats:italic><jats:sub>NDM<\/jats:sub> (17\/25) and <jats:italic>bla<\/jats:italic><jats:sub>OXA-48<\/jats:sub> (6\/25), (ii) most commonly observed plasmid replicons among the <jats:italic>K. pneumoniae<\/jats:italic> isolates recovered from Ukrainian patients were Col(pHAD28) (12\/14), IncHI1B(pNDM-MAR) (9\/14), IncFIB(pNDM-Mar) (12\/14), and (iii) clonal relation between the pathogens of the Ukrainian isolates, but not for the isolates from our hospital surveillance system.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The rising prevalence of community-acquired colonization and infection with CPGN is having a direct effect on the infection prevention measures, such as higher number of isolations, reprocessing of patient rooms, additional microbiological testing and overall organization within hospitals.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s15010-023-02061-4","type":"journal-article","created":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T11:02:58Z","timestamp":1687258978000},"page":"1731-1738","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Multidrug-resistant isolates from Ukrainian patients in a German health facility: a genomic surveillance study focusing on antimicrobial resistance and bacterial relatedness"],"prefix":"10.1007","volume":"51","author":[{"given":"Claudia","family":"Stein","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Zechel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Spott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias W.","family":"Pletz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Kipp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,6,20]]},"reference":[{"key":"2061_CR1","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1016\/S0140-6736(21)02724-0","volume":"399","author":"Antimicrobial Resistance C","year":"2022","unstructured":"Antimicrobial Resistance C. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022;399:629\u201355. https:\/\/doi.org\/10.1016\/S0140-6736(21)02724-0. (PMID: 35065702).","journal-title":"Lancet"},{"key":"2061_CR2","unstructured":"Antimicrobial resistance surveillance in Europe 2022 \u2013 2020 data. WHO Regional Office for Europe; 2022; Copenhagen"},{"key":"2061_CR3","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.jhin.2021.03.020","volume":"112","author":"V Kondratiuk","year":"2021","unstructured":"Kondratiuk V, Jones BT, Kovalchuk V, Kovalenko I, Ganiuk V, Kondratiuk O, et al. Phenotypic and genotypic characterization of antibiotic resistance in military hospital-associated bacteria from war injuries in the Eastern Ukraine conflict between 2014 and 2020. J Hosp Infect. 2021;112:69\u201376. https:\/\/doi.org\/10.1016\/j.jhin.2021.03.020. (PMID: 33789157).","journal-title":"J Hosp Infect"},{"key":"2061_CR4","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.jhin.2022.10.007","volume":"131","author":"A Salmanov","year":"2022","unstructured":"Salmanov A, Shchehlov D, Svyrydiuk O, Bortnik I, Mamonova M, Korniyenko S, et al. Epidemiology of healthcare-associated infections and mechanisms of antimicrobial resistance of responsible pathogens in Ukraine: a multicentre study. J Hosp Infect. 2022;131:129\u201338. https:\/\/doi.org\/10.1016\/j.jhin.2022.10.007. (PMID: 36306892).","journal-title":"J Hosp Infect"},{"key":"2061_CR5","unstructured":"Operational public health considerations for the prevention and control of infectious diseases in the context of Russia\u2019s aggression towards Ukraine. 2022; Stockholm."},{"key":"2061_CR6","doi-asserted-by":"publisher","first-page":"2200926","DOI":"10.2807\/1560-7917.ES.2022.27.50.2200926","volume":"27","author":"M Sandfort","year":"2022","unstructured":"Sandfort M, Hans JB, Fischer MA, Reichert F, Cremanns M, Eisfeld J, et al. Increase in NDM-1 and NDM-1\/OXA-48-producing Klebsiella pneumoniae in Germany associated with the war in Ukraine, 2022. Eurosurveillance. 2022;27:2200926. https:\/\/doi.org\/10.2807\/1560-7917.ES.2022.27.50.2200926.","journal-title":"Eurosurveillance"},{"key":"2061_CR7","doi-asserted-by":"publisher","first-page":"3","DOI":"10.25646\/10447","volume":"36","author":"NTH Dietze","year":"2022","unstructured":"Dietze NTH, Sch\u00f6nherr SG, Lippmann N, Ranft D, Fichtner F, Laudi S, Notov D, H\u00f6ch A, Kleber C, L\u00fcbbert C. Infektionsmedizinische und chirurgische Herausforderungen durch Carbapenem-resistente bakterielle Erreger bei der Versorgung Kriegsverletzter aus der Ukraine. Epid Bull. 2022;36:3\u201310. https:\/\/doi.org\/10.25646\/10447.","journal-title":"Epid Bull"},{"key":"2061_CR8","doi-asserted-by":"publisher","first-page":"2200896","DOI":"10.2807\/1560-7917.ES.2022.27.50.2200896","volume":"27","author":"RD Zwittink","year":"2022","unstructured":"Zwittink RD, Wielders CC, Notermans DW, Verkaik NJ, Schoffelen AF, Witteveen S, et al. Multidrug-resistant organisms in patients from Ukraine in the Netherlands, March to August 2022. Eurosurveillance. 2022;27:2200896. https:\/\/doi.org\/10.2807\/1560-7917.ES.2022.27.50.2200896.","journal-title":"Eurosurveillance"},{"key":"2061_CR9","doi-asserted-by":"publisher","first-page":"2640","DOI":"10.1093\/jac\/dks261","volume":"67","author":"E Zankari","year":"2012","unstructured":"Zankari E, Hasman H, Cosentino S, Vestergaard M, Rasmussen S, Lund O, et al. Identification of acquired antimicrobial resistance genes. J Antimicrob Chemother. 2012;67:2640\u20134. https:\/\/doi.org\/10.1093\/jac\/dks261. 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J Glob Antimicrob Resist. 2021;27:332\u20134. https:\/\/doi.org\/10.1016\/j.jgar.2021.09.012. (PMID: 34800709).","journal-title":"J Glob Antimicrob Resist"},{"key":"2061_CR13","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1586\/erp.09.53","volume":"9","author":"PW Stone","year":"2009","unstructured":"Stone PW. Economic burden of healthcare-associated infections: an American perspective. Expert Rev Pharmacoecon Outcomes Res. 2009;9:417\u201322. https:\/\/doi.org\/10.1586\/erp.09.53. (PMID: 19817525).","journal-title":"Expert Rev Pharmacoecon Outcomes Res"},{"key":"2061_CR14","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1016\/j.ajic.2021.11.025","volume":"50","author":"AS McAlearney","year":"2022","unstructured":"McAlearney AS, MacEwan SR, Gregory ME, Sova LN, Hebert C, Gaughan AA. Identifying management practices for promoting infection prevention: perspectives on strategic communication. 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(PMID: 22511638).","journal-title":"J Antimicrob Chemother"}],"container-title":["Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-023-02061-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s15010-023-02061-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-023-02061-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T11:06:15Z","timestamp":1700651175000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s15010-023-02061-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,20]]},"references-count":18,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["2061"],"URL":"https:\/\/doi.org\/10.1007\/s15010-023-02061-4","relation":{},"ISSN":["0300-8126","1439-0973"],"issn-type":[{"value":"0300-8126","type":"print"},{"value":"1439-0973","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,20]]},"assertion":[{"value":"26 May 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 June 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 June 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no relevant financial or non-financial interests to disclose. The authors have no competing interests to declare that are relevant to the content of this article. The authors have no financial or proprietary interests in any material discussed in this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the Ethics committee of the Jena University Hospital (Reg-Nr.: 2023-2918-Daten) conducted in accordance with the relevant ethical guidelines and regulations. Informed consent was waived by the Ethics committee considering the study design and adherence to the relevant guidelines. In particular, study data were deidentified to protect privacy and preserve the confidentiality of the study participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}