After Russia’s full-scale invasion, thousands of patients have been transferred from Ukraine to other European countries. A study by the University of Helsinki and HUS Helsinki University Hospital showed that 8% of Ukrainian refugees had been hospitalised due to war injuries. Almost 80% of them carried multidrug resistant (MDR) bacteria.
Highest risk among patients hospitalised with war injuries
The study found that non-hospitalised refugees carried no more multidrug-resistant bacteria than previously shown for Finns who had travelled in Asia, Africa or South America.
“Concerns about the risk of antimicrobial resistance relate specifically to patients who have been hospitalised in conflict-affected areas. Patients with war injuries were found to carry highly resistant bacteria, which often caused serious infections,” says Professor Anu Kantele of the University of Helsinki, who led the study.
Multidrug-resistant bacteria spread across borders
Healthcare systems in war zones are particularly vulnerable to the spread of multidrug-resistant bacteria.
“Hospitals in such areas are overburdened, and effective infection prevention is impossible. These conditions facilitate the spread of difficult-to-treat bacteria,” notes Kantele.
Ukrainian refugees who had not been hospitalised abroad before arriving in Finland were clearly less likely to carry multidrug-resistant bacteria. They were found to carry mainly ESBL-producing E. coli bacteria and, in individual patients, MRSA bacteria.
“Ordinary citizens need not worry. The problem relates specifically to hospital settings,” emphasises Doctoral Researcher Tuomas Aro , who is specialising in infectious diseases.
The Finnish healthcare system is prepared to tackle the challenge. At Finnish hospitals, patients previously hospitalised abroad are placed in single rooms, with contact isolation measures in place and bacterial samples taken.
“It’s important to understand that the prevalence of antimicrobial resistance is no more common among ordinary refugees than among Finns after a trip to Asia, for instance,” says Kantele.
Clinical Microbiology and Infection
Data/statistical analysis
People
War on AMR: High MDR carriage rates among war-injured Ukrainian refugees
21-Jul-2025