Cumulative antibiogram results of over 6800 diagnostic isolates from the First Lviv Territorial Medical Union, Ukraine

A study involving over 6800 diagnostic isolates from the First Lviv Territorial Medical Union (1TMO) in Western Ukraine reveals widespread antibiotic resistance among Gram-negative organisms. Klebsiella pneumoniae was the most prevalent Gram-negative species, with 51% having extended spectrum β-lactamase production, 73% having resistance to ciprofloxacin, and 28% being resistant to all tested antibiotics. Acinetobacter spp showed high rates of resistance, with 76% of Acinetobacter spp being carbapenem resistant and 37% being resistant to all tested antibiotics. Pseudomonas aeruginosa isolates also showed widespread resistance, with susceptibility to first-line agents falling below global averages. The Ukrainian Ministry of Health and the Ministry of Defence recommend oral moxifloxacin or ciprofloxacin as prehospital antibacterial prophylaxis for injured adults. Quinolones are used as second-line prophylaxis in military trauma stabilization points and hospitals, but resistance to quinolones among staphylococci and Gram-negative isolates was high, with 71% MRSA resistant. The study highlights the need for clinicians to educate clinicians about the inevitable colonization of open wounds with bacteria and to reserve antibiotic treatment to those with clinical signs of infection.