Operationalising antimicrobial resistance surveillance data in conflict areas

Hailie Uren and colleagues have published the first substantial volume of clinical antimicrobial susceptibility testing data set in Ukraine, which broadens regional situational awareness and validates concerns about the spread of multidrug-resistant infections in those requiring inpatient health care due to conflict. They call for more widespread surveillance to better understand the microbiological profiles of those with conflict-associated injuries, which will enable effective empirical antimicrobial prescribing guidelines in the prehospital space. The data shows high proportions of resistance among current first-line options of moxifloxacin or ciprofloxacin, but this should be considered in the context of the wider patient care pathway. More granular data are urgently required to understand the transmission dynamics of resistance genes among at-risk conflict and catastrophe populations before they can have an effect on wider empirical treatment choices