{"id":688688,"date":"2025-09-03T13:30:38","date_gmt":"2025-09-03T10:30:38","guid":{"rendered":"https:\/\/buradabiliyorum.com\/en\/how-human-conflict-accelerates-antimicrobial-resistance\/"},"modified":"2025-09-03T13:30:38","modified_gmt":"2025-09-03T10:30:38","slug":"how-human-conflict-accelerates-antimicrobial-resistance","status":"publish","type":"post","link":"https:\/\/buradabiliyorum.com\/en\/how-human-conflict-accelerates-antimicrobial-resistance\/","title":{"rendered":"How human conflict accelerates antimicrobial resistance"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_84 counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of Contents<\/p>\n<label for=\"ez-toc-cssicon-toggle-item-6a2e0fc4dc29f\" class=\"ez-toc-cssicon-toggle-label\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #dd3333;color:#dd3333\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #dd3333;color:#dd3333\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/label><input type=\"checkbox\"  id=\"ez-toc-cssicon-toggle-item-6a2e0fc4dc29f\" checked aria-label=\"Toggle\" \/><nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/buradabiliyorum.com\/en\/how-human-conflict-accelerates-antimicrobial-resistance\/#Hard_choices_Life_over_AMR\" >Hard choices: Life over AMR<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/buradabiliyorum.com\/en\/how-human-conflict-accelerates-antimicrobial-resistance\/#Antibiotic_chaos_Overuse_drives_AMR\" >Antibiotic chaos: Overuse drives AMR<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/buradabiliyorum.com\/en\/how-human-conflict-accelerates-antimicrobial-resistance\/#AMR_without_borders\" >AMR without borders<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/buradabiliyorum.com\/en\/how-human-conflict-accelerates-antimicrobial-resistance\/#Environmental_accelerators\" >Environmental accelerators<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/buradabiliyorum.com\/en\/how-human-conflict-accelerates-antimicrobial-resistance\/#AMR_is_a_global_challenge\" >AMR is a global challenge<\/a><\/li><\/ul><\/nav><\/div>\n<div>\n<div class=\"article-gallery lightGallery\">\n<div data-thumb=\"https:\/\/scx1.b-cdn.net\/csz\/news\/tmb\/2023\/war-1.jpg\" data-src=\"https:\/\/scx2.b-cdn.net\/gfx\/news\/hires\/2023\/war-1.jpg\" data-sub-html=\"Credit: \u0410\u043b\u0435\u0441\u044c \u0423\u0441\u0446\u0456\u043d\u0430\u045e from Pexels\">\n<figure class=\"article-img\">\n            <img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/scx1.b-cdn.net\/csz\/news\/800a\/2023\/war-1.jpg\" alt=\"war\" title=\"Credit: \u0410\u043b\u0435\u0441\u044c \u0423\u0441\u0446\u0456\u043d\u0430\u045e from Pexels\" width=\"800\" height=\"530\"\/><figcaption class=\"text-darken text-low-up text-truncate-js text-truncate mt-3\">\n                Credit: \u0410\u043b\u0435\u0441\u044c \u0423\u0441\u0446\u0456\u043d\u0430\u045e from Pexels<br \/>\n            <\/figcaption><\/figure>\n<\/p><\/div>\n<\/div>\n<p>Human conflict, from minor disruptions to the all-too frequent escalation of war, stretches people and the environment to its limits. At the same time, microorganisms create an equally devastating\u2014but largely invisible\u2014scene.<\/p>\n<p>During times of human conflict, infections thrive among the wounded and overcrowded, and the surrounding environment is likely to become contaminated with heavy metals and unsafe water, which further propagates the spread of disease.<\/p>\n<p>Meanwhile, hospitals struggle to save lives with restricted resources (e.g., shortages of medical staff, medications and supplies), and people have difficulty accessing, or simply cannot access, health care if\/when it is available.<\/p>\n<p>In short, conflict fuels the uncontrolled spread of infections in environments where proper health care is hard to come by, which leads to misuse of antibiotics without proper diagnosis and treatment. This, in turn, allows pathogens to rapidly develop antimicrobial resistance (AMR).<\/p>\n<p>Understanding the factors driving AMR in areas of conflict can be difficult, and take time to assess, as research, understandably, does not take precedence during triage. Yet, a look back at conflicts that have occurred over the past 20+ years reveals some noteworthy trends.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Hard_choices_Life_over_AMR\"><\/span>Hard choices: Life over AMR<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>During times of human conflict, medical professionals face impossible choices. For instance, in the Gaza S<a href=\"https:\/\/buradabiliyorum.com\/en\/category\/trip-and-travel\/\" data-internallinksmanager029f6b8e52c=\"10\" title=\"Trip &amp; Travel\" target=\"_blank\" rel=\"noopener\">trip<\/a>, <a rel=\"nofollow\" target=\"_blank\" href=\"https:\/\/medicalxpress.com\/news\/2023-11-gaza-tragedy-disease-overcrowded-dirty.html\" target=\"_blank\">already exhausted and under-resourced<\/a> individuals must prioritize im<a href=\"https:\/\/buradabiliyorum.com\/en\/category\/social-mediaa\/\" data-internallinksmanager029f6b8e52c=\"1\" title=\"Social Media\" target=\"_blank\" rel=\"noopener\">media<\/a>te lifesaving interventions in locations that are often under continuous threat or bombardment.<\/p>\n<p>Every minute that could be spent determining <a href=\"https:\/\/buradabiliyorum.com\/en\/category\/download-scripts-themes-apps\/\" data-internallinksmanager029f6b8e52c=\"9\" title=\"Download Scripts &amp; Themes &amp; Apps\" target=\"_blank\" rel=\"noopener\">app<\/a>ropriate antibiotic protocols is, instead, used to save a limb or a life, leaving limited capacity to monitor or address how far AMR may have spread during the war.<\/p>\n<p>Research supports this concern: during the 2018 Great March of Return protests in Gaza\u2014an event far less violent than the conflict that began in 2023\u2014microbes isolated from wounded individuals showed <a rel=\"nofollow\" target=\"_blank\" href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(22)01149-7\/fulltext\" target=\"_blank\">AMR increases of up to 300% for specific antibiotics compared to samples from non-wounded individuals<\/a>. Although the data are not yet available, the current situation, with its greater scale of casualties and damage, likely presents an even more alarming escalation of AMR.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Antibiotic_chaos_Overuse_drives_AMR\"><\/span>Antibiotic chaos: Overuse drives AMR<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Regulated antibiotic use becomes nearly impossible when wars drive widespread infections, complicated wounds, collapsed health facilities and disrupted supply chains. <a rel=\"nofollow\" target=\"_blank\" href=\"https:\/\/doi.org\/10.1038\/s43856-023-00386-7\" target=\"_blank\">Syria provides a stark example<\/a>: following the onset of civil war in 2011, which devastated domestic antibiotic production (previously covering 90% of national needs), antibiotics were sold without prescription in more than 85% of cases. This unregulated distribution creates ideal conditions for the development of resistance.<\/p>\n<p>The effects of antimicrobial overuse in a conflict-ridden environment have also been realized as an increased prevalence of macrolide resistant Vibrio cholerae isolates in Yemen. By the time an <a rel=\"nofollow\" target=\"_blank\" href=\"https:\/\/www.iom.int\/news\/acute-diarrhea-and-cholera-outbreak-yemen-exacerbated-decade-conflict-iom-warns\" target=\"_blank\">outbreak of cholera<\/a> began in Yemen in October 2016, the ongoing Yemen Civil War, which began in September 2014, had <a rel=\"nofollow\" target=\"_blank\" href=\"https:\/\/doi.org\/10.3855\/jidc.10129\" target=\"_blank\">significantly compromised an already fragile health system<\/a>, leaving more than 14 million people with limited access to health care and creating ideal conditions for the cholera epidemic spread.<\/p>\n<p>Physicians used macrolides extensively to combat Yemen&#8217;s cholera epidemic\u2014the largest in the country&#8217;s history\u2014which continued to spread even after the World Health Organization&#8217;s mass vaccination campaign in 2018.<\/p>\n<p>By early 2019, all tested V. cholerae organisms showed acquisition of a new plasmid conferring resistance to many frontline antibiotics used to treat cholera, including macrolides. The outbreak continued until 2022.<\/p>\n<div class=\"ads w-100 my-4 article-main__more bg-light p-3 border\" aria-hidden=\"true\">\n<p class=\"mb-3\">\n        Discover the latest in <a href=\"https:\/\/buradabiliyorum.com\/en\/category\/sciencee\/\" data-internallinksmanager029f6b8e52c=\"5\" title=\"Science\" target=\"_blank\" rel=\"noopener\">science<\/a>, tech, and space with over <strong>100,000 subscribers<\/strong> who rely on Phys.org for daily insights.<br \/>\n        Sign up for our <a rel=\"nofollow\" target=\"_blank\" href=\"https:\/\/sciencex.com\/help\/newsletter\/\" target=\"_blank\">free newsletter<\/a> and get updates on breakthroughs,<br \/>\n        innovations, and research that matter\u2014<strong>daily or weekly<\/strong>.\n    <\/p>\n<\/div>\n<h2><span class=\"ez-toc-section\" id=\"AMR_without_borders\"><\/span>AMR without borders<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Population displacement represents another critical factor in AMR proliferation beyond conflict zones. <a rel=\"nofollow\" target=\"_blank\" href=\"https:\/\/yemen.un.org\/en\/about\/about-the-un\" target=\"_blank\">More than 3 million Yemenis have been displaced<\/a> since 2015, contributing to resistance spread across new regions. Similar patterns emerged in countries receiving people from Iraq, Libya, Syria and, more recently, Ukraine\u2014the fastest-growing refugee crisis in Europe since World War II.<\/p>\n<p><a rel=\"nofollow\" target=\"_blank\" href=\"https:\/\/doi.org\/10.1038\/s43856-023-00386-7\" target=\"_blank\">Evidence from the Netherlands and Germany<\/a> shows that Ukrainians displaced during the current conflict tested positive for multiple drug-resistant organisms (MDROs) at significantly higher rates than pre-conflict travelers from the same region. This pattern demonstrates how war conditions can rapidly transform regional resistance profiles.<\/p>\n<p><a rel=\"nofollow\" target=\"_blank\" href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(23)02508-4\/fulltext\" target=\"_blank\">Gaza presents a unique case<\/a>. Approximately 1.5 million people have been displaced; 117,000 used hospitals as sanctuaries. Al-Shifa Hospital Complex alone hosted more than 50,000 internally displaced persons (IDPs).<\/p>\n<p>Two-thirds of hospitals became non-functional, while the remaining reported fuel shortages and a lack of medical staff. While we do not yet have data pertaining to the spread of resistance in this region, the above conditions create an environment where AMR is likely to thrive.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Environmental_accelerators\"><\/span>Environmental accelerators<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>In addition to creating conditions of overcrowding, lack of access to medical care and population displacement, human conflict also introduces dangerous levels of environmental contamination. For example, infrastructure destruction breaks down water and sanitation systems, creating reservoirs for AMR organisms to multiply and spread.<\/p>\n<p>This scenario becomes more serious in regions where pre-existing contamination of water and the surrounding environment is already high. For example, <a rel=\"nofollow\" target=\"_blank\" href=\"https:\/\/medicalxpress.com\/news\/2023-11-gaza-tragedy-disease-overcrowded-dirty.html\" target=\"_blank\">34% of hospital water samples in the Gaza Strip were already contaminated<\/a> prior to the 2023 Gaza War.<\/p>\n<p>Heavily bombed sites may also show contamination with heavy metals, which can lead to the <a rel=\"nofollow\" target=\"_blank\" href=\"https:\/\/doi.org\/10.21608\/MID.2023.204635.1503\" target=\"_blank\">selection of resistant pathogens,<\/a> including <a rel=\"nofollow\" target=\"_blank\" href=\"https:\/\/www.frontiersin.org\/journals\/microbiology\/articles\/10.3389\/fmicb.2020.00068\/full\" target=\"_blank\">Acinetobacter baumannii<\/a>, an opportunistic pathogen notorious for causing hospital-acquired infections. In Ukraine in 2022, A. baumannii strains showed <a rel=\"nofollow\" target=\"_blank\" href=\"https:\/\/www.journalofhospitalinfection.com\/article\/S0195-6701(24)00231-7\/abstract\" target=\"_blank\">72% and 67% increased resistance to the critical antibiotics meropenem and imipenem<\/a>, respectively.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"AMR_is_a_global_challenge\"><\/span>AMR is a global challenge<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>AMR is not just a local problem confined to conflict zones\u2014it represents a global health security threat that crosses borders. However, it is often masked by <a rel=\"nofollow\" target=\"_blank\" href=\"https:\/\/doi.org\/10.1186\/s40249-025-01287-8\" target=\"_blank\">compromised surveillance systems<\/a> in conflict areas where microbiological laboratory activities are disrupted. This suggests that during times of conflict, AMR is significantly underreported, undetected and unaddressed.<\/p>\n<p>Without a coordinated international response, conflict-accelerated AMR will continue to diminish our ability to treat infections, leading to increased mortality, morbidity and health care costs worldwide.<\/p>\n<p>Humanitarian responses to conflicts must integrate AMR strategies, even in the presence of competing urgent needs. This can be achieved by using available data, collected prior to the conflict, about local AMR patterns to train first responders to use the appropriate antibiotics (which should be included in their emergency kits). It is also critical to prioritize clean water supply and wastewater management in IDP camps.<\/p>\n<p>Additionally, post-conflict reconstruction efforts should rebuild robust antimicrobial stewardship programs and surveillance systems, possibly by building on <a rel=\"nofollow\" target=\"_blank\" href=\"https:\/\/doi.org\/10.1186\/s13756-023-01301-4\" target=\"_blank\">the interventions of humanitarian organizations during the conflict<\/a>.<\/p>\n<p>Examples include M\u00e9decins sans Fronti\u00e8res&#8217; electronic clinical decision support system (E-care) in Kenya, which reduced 50% of antibiotic prescriptions for children under 5 in primary health settings, and the International Committee of the Red Cross, ICRC&#8217;s six-year antimicrobial stewardship program (2015\u20132021) at a reconstructive Lebanese surgical project, which established dedicated protocols, laboratory-guided prescribing and infection control measures that can be used as guide for the post-conflict systems.<\/p>\n<p>The battle against unseen microbial enemies demands as much attention as the visible horrors of war if we are to preserve the effectiveness of our most critical medications for future generations.<\/p>\n<div class=\"d-inline-block text-medium mt-4\">\n<p>\n\t\t\t\t\t\t\t\t\t\t\t\t\tProvided by<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tAmerican Society for Microbiology<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a rel=\"nofollow\" target=\"_blank\" class=\"icon_open\" href=\"http:\/\/www.asm.org\/\" target=\"_blank\" rel=\"nofollow\"><br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<svg>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<use href=\"https:\/\/phys.b-cdn.net\/tmpl\/v6\/img\/svg\/sprite.svg#icon_open\" x=\"0\" y=\"0\"\/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/svg><br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n<\/p><\/div>\n<p>\t\t\t\t\t\t\t\t\t\t<!-- print only --><\/p>\n<div class=\"d-none d-print-block\">\n<p>\n\t\t\t\t\t\t\t\t\t\t\t\t<strong>Citation<\/strong>:<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\tHow human conflict accelerates antimicrobial resistance (2025, September 3)<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\tretrieved 3 September 2025<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\tfrom https:\/\/phys.org\/<a href=\"https:\/\/buradabiliyorum.com\/en\/category\/news\/\" data-internallinksmanager029f6b8e52c=\"2\" title=\"News\" target=\"_blank\" rel=\"noopener\">news<\/a>\/2025-09-human-conflict-antimicrobial-resistance.html\n\t\t\t\t\t\t\t\t\t\t\t <\/p>\n<p>\n\t\t\t\t\t\t\t\t\t\t\t This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no<br \/>\n\t\t\t\t\t\t\t\t\t\t\t part may be reproduced without the written permission. The content is provided for information purposes only.\n\t\t\t\t\t\t\t\t\t\t\t <\/p>\n<\/p><\/div>\n<\/p><\/div>\n<p><script id=\"facebook-jssdk\" async=\"\" src=\"https:\/\/connect.facebook.net\/en_US\/sdk.js\"><\/script><\/p>\n<blockquote><p><strong><span style=\"color: #ff6600;\">If you liked the article, do not forget to share it with your friends. Follow us on\u00a0<span style=\"color: #ff0000;\"><a style=\"color: #ff0000;\" href=\"https:\/\/news.google.com\/publications\/CAAqBwgKMN63nwsw68G3Aw\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Google News<\/a><\/span>\u00a0too, click on the star and choose us from your favorites.<\/span><\/strong><\/p><\/blockquote>\n<blockquote>\n<p style=\"text-align: center;\"><strong>If you want to read more Like this articles, you can visit our <span style=\"color: #ff9900;\"><a style=\"color: #ff9900;\" href=\"https:\/\/buradabiliyorum.com\/en\/category\/sciencee\/\" target=\"_blank\" >Science category.<\/a><\/span><\/strong><\/p>\n<\/blockquote>\n<p><span style=\"color: black;\"><a style=\"color: #ff9900;\" href=\"https:\/\/phys.org\/news\/2025-09-human-conflict-antimicrobial-resistance.html\" target=\"_blank\" >Source<\/a><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Credit: \u0410\u043b\u0435\u0441\u044c \u0423\u0441\u0446\u0456\u043d\u0430\u045e from Pexels Human conflict, from minor disruptions to the all-too frequent escalation of war, stretches people and the environment to its limits. At the same time, microorganisms create an equally devastating\u2014but largely invisible\u2014scene. During times of human conflict, infections thrive among the wounded and overcrowded, and the surrounding environment is likely to&#8230;<\/p>\n","protected":false},"author":1,"featured_media":688689,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"fifu_image_url":"https:\/\/scx2.b-cdn.net\/gfx\/news\/hires\/2023\/war-1.jpg","fifu_image_alt":"","footnotes":""},"categories":[16],"tags":[],"class_list":["post-688688","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sciencee"],"_links":{"self":[{"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/posts\/688688","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/comments?post=688688"}],"version-history":[{"count":0,"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/posts\/688688\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/media\/688689"}],"wp:attachment":[{"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/media?parent=688688"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/categories?post=688688"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/tags?post=688688"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}