Costescu Strachinaru Diana Isabela, Ragot Céline, Stoefs Anke, Donat Nicolas, François Pierre-Michel, Vanbrabant Peter, Verroken Alexia, Janvier Frédéric, Soentjens Patrick
Center for Infectious Diseases, Queen Astrid Military Hospital, 1120 Brussels, Belgium.
HOST Iris, 1000 Brussels, Belgium.
Trop Med Infect Dis. 2025 May 8;10(5):128. doi: 10.3390/tropicalmed10050128.
The growing threat of antimicrobial resistance (AMR) is a critical issue for both civilians and the military. With each successive conflict, pathogens become more resistant, making the management of infections in casualties increasingly challenging. To better understand the scope and characteristics of conflict-related AMR, a comprehensive literature search was conducted in the PubMed database in April 2025, using defined search terms related to war casualties and antimicrobial resistance. We screened and included 117 relevant publications, comprising original research articles, reviews, case series, case reports, editorials, and commentaries, published in English or French, with no date restriction. This narrative review synthesizes current evidence on multidrug-resistant bacteria most commonly isolated from war casualties, their associated resistance mechanisms, and the microbiological diagnostic tools available at various levels of the military continuum of care (Roles 1-4). It also presents strategies for preventing cross-contamination and infection in resource-limited combat settings and provides practical, field-adapted recommendations for clinicians, from first responders to specialized care providers, aiming to improve infection management in armed conflict zones and mitigate the spread of AMR.
抗菌药物耐药性（AMR）日益增长的威胁对平民和军队来说都是一个关键问题。随着冲突的不断延续，病原体的耐药性越来越强，使得伤亡人员感染的管理变得愈发具有挑战性。为了更好地了解与冲突相关的AMR的范围和特征，于2025年4月在PubMed数据库中进行了全面的文献检索，使用了与战争伤亡人员和抗菌药物耐药性相关的特定检索词。我们筛选并纳入了117篇相关出版物，包括原始研究文章、综述、病例系列、病例报告、社论和评论，这些文章以英文或法文发表，无日期限制。本叙述性综述综合了目前关于从战争伤亡人员中最常分离出的多重耐药细菌、其相关耐药机制以及在军事连续护理的各个层面（第1 - 4级）可用的微生物诊断工具的证据。它还介绍了在资源有限的战斗环境中预防交叉污染和感染的策略，并为从一线急救人员到专科护理人员的临床医生提供了适用于实地的实用建议，旨在改善武装冲突地区的感染管理并减轻AMR的传播。
