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High Prevalence of Multidrug-Resistant Bacteria in Libyan War Casualties Admitted to a Tertiary Care Hospital,

Benedikt Lohr1, Yvonne Pfeifer2, Ursel Heudorf3

  • 11 Institute for Laboratory Medicine , Microbiology & Infection Control, Northwest Medical Centre, Frankfurt/Main, Germany .

Microbial Drug Resistance (Larchmont, N.Y.)
|October 18, 2017
PubMed

Insights

Libyan war casualties admitted to Germany had a high rate of multidrug-resistant organisms (MDROs), including carbapenem-resistant gram-negative organisms (CROs) and methicillin-resistant Staphylococcus aureus (MRSA). This highlights the risk of cross-border infectious disease transmission.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Public Health

Background:

  • The Libyan conflict poses a significant risk for the cross-border spread of multidrug-resistant organisms (MDROs).
  • War casualties are vulnerable to infections, and their transfer can introduce resistant pathogens into new healthcare settings.

Purpose of the Study:

  • To assess the prevalence of MDROs in Libyan war casualties treated in Germany.
  • To identify specific MDROs and their resistance mechanisms.

Main Methods:

  • Screening of 67 Libyan war casualties admitted to a German medical center from August 2016 to January 2017.
  • Molecular detection of resistance genes (e.g., β-lactamases, quinolone resistance genes) in identified MDROs.
  • Bacterial strain typing using enzymatic macrorestriction and pulsed-field gel electrophoresis.

Main Results:

  • MDROs were detected in 60% of patients (40/67).
  • Carbapenem-resistant gram-negative organisms (CROs) were found in 37% (25/67), and methicillin-resistant Staphylococcus aureus (MRSA) in 16% (11/67).
  • Common carbapenemases included NDM, OXA-48, and OXA-23, alongside other β-lactamases and quinolone resistance genes. Various bacterial clones were identified.

Conclusions:

  • Libyan war casualties carry a substantial burden of MDROs, posing a significant public health risk.
  • Effective screening and containment strategies are crucial for healthcare institutions receiving such patients to prevent onward transmission.
Keywords:
Acinetobacter baumanniiEnterobacteriaceaeNDMOXAcarbapenemasemultidrug resistance

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