Work

Molecular epidemiology and virulence profiles of MDR and XDR Pseudomonas aeruginosa from combat-related wounds in Ukraine

Year: 2026

Type: article

Abstract: Background Combat-related injuries sustained during the ongoing conflict in Ukraine have been associated with infections caused by multidrug-resistant Gram-negative bacteria, raising concerns about treatment options and cross-border transmission to receiving healthcare systems. Pseudomonas aeruginosa is among the most clinically significant pathogens in this setting. This study aimed to define the molecular epidemiology of P. aeruginosa from combat-related wounds in Ukraine and to link genomic resistance and virulence determinants to antimicrobial susceptibility and virulence phenotypes. Methods P. aeruginosa isolates from distinct wound patients (n=13, Dec 2024–Jun 2025) underwent whole-genome sequencing, SNP-based phylogenetic analysis, and screening of acquired resistance genes and chromosomal resistance-associated mutations. Antimicrobial susceptibility testing followed EUCAST, and carbapenemase production was assessed phenotypically. Virulence profiling included exoU/exoS carriage, 3-oxo-C12-HSL and C4-HSL production, and pyocyanin and rhamnolipid production. Results Ten sequence types were identified, including ST235, ST244, ST773, and ST1047, indicating high clonal diversity rather than a single outbreak lineage. All isolates were non-susceptible to ciprofloxacin, ceftazidime, piperacillin–tazobactam, and aztreonam; 5/13 were non-susceptible to ceftolozane–tazobactam and 4/13 were meropenem-resistant. Carbapenemase-positive isolates carried bla IMP-1 (3/13) or bla NDM-1 (1/13). Resistance-associated chromosomal variation affected porins, efflux regulators, and β-lactam response pathways. Virulence profiles were heterogeneous, with mutually exclusive exoU (7/13) or exoS (6/13) carriage and variable pyocyanin and rhamnolipid production. Conclusions These data provide genomic and phenotypic characterisations of combat-wound P. aeruginosa from Ukraine, highlighting substantial diversity and frequent multidrug-resistant phenotypes and supporting lineage-resolved genomic surveillance in conflict-associated care pathways.

Source: New Microbes and New Infections

DOI: 10.1016/j.nmni.2026.101880