Six Extensively Drug-Resistant Bacteria in an Injured Soldier, Ukraine

From a Research Letter to CDC's Emerging Infectious Diseases, Fall 2023 Issue:

"A man in his mid-50s suffered multiple traumatic injuries after a vehicle fire, including full-thickness burns covering 60% of his total body surface. He was initially treated in a medical facility near Dnipro, Ukraine, before being transferred to a hospital in Kyiv, Ukraine, where healthcare practitioners performed burn wound debridement and escharotomies. Thereafter, the patient was transported to a US military hospital in Germany, where doctors obtained blood, urine, respiratory, and peri-rectal surveillance cultures."

These cultures grew six extensively drug-resistant bacteria: A. baumannii, Enterococcus faecium, Klebsiella pneumoniae, and 3 distinct morphologies of P. aeruginosa. These bacteria were found to be non-susceptible to almost every antibiotic tested against them.

 https://wwwnc.cdc.gov/eid/article/29/8/23-0567_article

Notable Trees and Plants of Ukraine

Pines / сосна : 9 species, including: 

Pinus silvestris

European Red Pine

Image by wikipedia

A long, bare, straight trunk, blue-green 1-2” long needles, and orange-red bark which ages to

brown make this tree distinctive. Grows in the poor soil of sandy or rocky areas and peat bogs;

tends to be outcompeted by spruce and broadleaf trees in more fertile soils. It is grown

commercially for pulp and timber.

Pinus mugo 

Mountain Pine

photo by Conifer Kingdom

Found at tree line in the Carpathians and at other high-elevation cold and wet places,

especially north

mountain slopes. A low, shrubby growth habit allows this pine to spring back after

being bent by heavy

snow loads. Useful for erosion control and avalanche breaks

Pinus cembra

Swiss Stone Pine

photo by Wikipedia

This slow-growing 5-needle pine lives at high elevations in the Carpathians

and other European mountain ranges. It produces edible pine nuts.

Fir / ялиця :9 species, including

Abies alba - Silver Fir

Images from Wikipedia

Inhabits the Carpathians mountains, where it grows up to 200’ tall. Ukraine’s

most ecologically and economically important fir. The timber is used for

construction and furniture-making. Bees “milk” aphids to produce an unusual

“fir honey”.

Deciduous Trees

Acer species

Maples / клен

Species include Tatar, Norway, and Sycamore maples.

Quercus robur

Oak / дуб

Image by woodland trust

Widespread on neutral-pH soils across Europe. Acorns tend to be produced every other year

in large quantities.

Fraxinus species

Ash / ясен

Image from Wikipedia

The European Ash is most widespread, and is used in furniture-making and building.

Ashes are members of the Olive tree family.

Tilia species: 

Linden Tree / липа

Image from thespruce.com

In Ukrainian, the month of July is named after this tree’s creamy golden,

sweetly scented flowers, which can be made into tea. The wood is used for

furniture and musical instrument-making.

Carpinus betulus - храб / European Hornbean

Grows at low elevations, often in mixed stands with oak and beech. This

medium-sized tree is useful as an urban street tree, and as firewood.

Fagus sylvatica- бук / European Beech

Images from Wikipedia

Produces shady, old-growth, end-sucession forests. Mature trees help to

nourish saplings in the shady understory, so that new beeches are prepared to

rapidly grow and fill in canopy gaps left by fallen trees.

 

Antimicrobial Resistance and the Ukrainian-Russian War

A joint CDC-Ukrainian Ministry of Health study, published on Dec 7 2023, examined rates of multiple-drug-resistant infections in 50 patients who acquired infections in Ukrainians hospitals in late 2022.

60% of these patients were infected by bacteria resistant to carbapenem antibiotics (high-end antimicrobials, generally used as a last resort when all else fails). 

The study also found that 14% of the 354 patients surveyed suffered from hospital-acquired infections. This can be compared to a 2016-17 EU-wide survey of 4,000 patients, which found a healthcare-associated infection rate of 5.5%, and a 6.2^% carbapenem-resistance rate.

"Worldwide, bacterial antimicrobial resistance is estimated to cause more deaths than HIV or malaria and is recognized as a leading global public health threat. In Ukraine, the confluence of high prewar rates of antimicrobial resistance, an increase in the prevalence of traumatic wounds and the war-related strain on health care facilities is leading to increased detection of multidrug-resistant organisms with spread into Europe," the study authors wrote in the Dec. 8 issue of the CDC publication Morbidity and Mortality Weekly Report.

Ukrainian Month Names: a colorful, nature-based calendar

January : Січень (“Sih-chen”)
Named for the tiny, sharp, wind-driven snowflakes that feel like they are
cutting the skin of your face.

February Лютий  (“Lyoo-tiy”)
лютий means “furious”- a reference to the final storms of winter

March Березень
  (“Byer-eh-zyen“)
This is the month when the fresh leaves of spring appear on the березень-birch
trees.

April Квітень
  (“Kvih-ten”)
“Flowers”
 (“Trah-ven”)
“Grass”

May Травень

 (“Trah-ven”)

“Grass”

June Червень
 (“Chyer-ven“)
Named after Porphyrophora polonica, the Polish cochineal scale insect. These bugs were
once common in the sandy soils of Central Europe. The larvae form subterranean
cysts on the roots of host plants, which were harvested in pre-industrial times to
make an economically important reddish-purple dye.

July Липень
 (“Lee-pen”)
When linden trees bloom, producing a ubiquitous lime-honeysuckle scent.

August Серпень
 (“Syer-pen”)
Harvest month- this word means “sickle”, seen in the Soviet hammer and sickle
emblem.

September Вересень
 (“Vyer-eh-sen“)
Named for the purple erica flowers sold in street kiosks in early fall.

October Жовтень
(“Zhyov-ten”)
“Yellow”- for the yellow leaves of autumn.

November Листопад
 (“Listo-pahd“)
“Falling leaves”

December грудень (“Grood-en”)
Named for груда- the small lumps of frozen soil that form
as temperatures fall.

Ukrainian Defense Ministry Expands Medical Eligibility Rules for Military Service

 On Sept 3, the Defense Ministry of Ukraine amended its list of medical conditions which exempt citizens from military service. Individuals with the following conditions are now considered fir for service: 

- clinically cured TB

- clinically cured hepatitis

- slowly progressing blood diseases

- slowly progressing CNS disorders

- minor thyroid issues

- HIV+ and asymptomatic

-mild mental and neurotic disorders