Enlarge / Ukrainian medics of the battalion "Da Vinci Wolves" and "Ulf" paramedical unit transfer a wounded Ukrainian soldier to a stabilization point on the Bakhmut front as the Russia-Ukraine war continues on April 6, 2023. (credit: Getty | Diego Herrera Carcedo/Anadolu Agency )

Russia's invasion of Ukraine is fueling a dangerous rise in bacterial drug resistance—an alarming reality made clear by a recent case report of an injured Ukrainian soldier who became infected with six different extensively drug-resistant bacteria, one of which was resistant to every antibiotic tested.

Health experts are sounding the alarm that the nearly unbeatable germs will likely spread beyond the war-torn country's borders. "Given the forced migration of the population, multidrug resistance of wound pathogens is now a problem not only for Ukraine but also for healthcare systems around the world, especially in the EU," Ukrainian scientists and doctors wrote in a recent letter in the Irish Journal of Medical Scientists.

The rise of antibiotic resistance is a long-standing, critical threat to global public health. In 2019, antimicrobial resistance was directly responsible for an estimated 1.27 million deaths worldwide and linked to an estimated 4.95 million total, according to an analysis published last year in the Lancet .

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Broad-spectrum antibiotics are akin to nuclear bombs, obliterating every prokaryote they meet. They're effective at eliminating pathogens, sure, but they're not so great for maintaining a healthy microbiome. Ideally, we need precision antimicrobials that can target only the harmful bacteria while ignoring the other species we need in our bodies, leaving them to thrive. Enter SNIPR BIOME , a Danish company founded to do just that. Its first drug—SNIPR001—is currently in clinical trials .

The drug is designed for people with cancers involving blood cells. The chemotherapy these patients need can cause immunosuppression along with increased intestinal permeability, so they can't fight off any infections they may get from bacteria that escape from their guts into their bloodstream. The mortality rate from such infections in these patients is around 15–20 percent. Many of the infections are caused by E. coli , and much of this E. coli is already resistant to fluoroquinolones, the antibiotics commonly used to treat these types of infections.

The team at SNIPR BIOME engineers bacteriophages, viruses that target bacteria, to make them hyper-selective. They started by screening 162 phages to find those that would infect a broad range of E. coli strains taken from people with bloodstream or urinary tract infections, as well as from the guts of healthy people. They settled on a set of eight different phages. They then engineered these phages to carry the genes that encode the CRISPR DNA-editing system, along with the RNAs needed to target editing to a number of essential genes in the E. coli genome. This approach has been shown to prevent the evolution of resistance.

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Two more people have died and more details of horrifying eye infections are emerging in a nationwide outbreak linked to recalled eye drops from EzriCare and Delsam .

The death toll now stands at three, according to an outbreak update this week from the Centers for Disease Control and Prevention. A total of 68 people in 16 states have been infected with a rare, extensively drug-resistant Pseudomonas aeruginosa strain linked to the eye drops. In addition to the deaths, eight people have reported vision loss and four have had their eyeballs surgically removed (enucleation).

In a case report published this week in JAMA Ophthalmology, eye doctors at the Bascom Palmer Eye Institute, part of the University of Miami Health System, reported details of one case linked to the outbreak—a case in a 72-year-old man who has an ongoing infection in his right eye with vision loss, despite weeks of treatment with multiple antibiotics. When the man first sought treatment he reported pain in his right eye, which only had the ability to detect motion at the point, while his left eye had 20/20 vision. Doctors noted that the white of his right eye was entirely red and white blood cells had visibly pooled on his cornea and in the front inner chamber of his eye.