Background: Combat-related injuries sustained during the ongoing conflict in Ukraine have been associated with infections caused by multidrug-resistant Gram-negative bacteria, raising concerns about treatment options and cross-border transmission to receiving healthcare systems. Pseudomonas aeruginosa is among the most clinically significant pathogens in this setting. This study aimed to define the molecular epidemiology of P. aeruginosa from combat-related wounds in Ukraine and to link genomic resistance and virulence determinants to antimicrobial susceptibility and virulence phenotypes. Methods: P. aeruginosa isolates from distinct wound patients (n = 13, Dec 2024–Jun 2025) underwent whole-genome sequencing, SNP-based phylogenetic analysis, and screening of acquired resistance genes and chromosomal resistance-associated mutations. Antimicrobial susceptibility testing followed EUCAST, and carbapenemase production was assessed phenotypically. Virulence profiling included exoU/exoS carriage, 3-oxo-C12-HSL and C4-HSL production, and pyocyanin and rhamnolipid production. Results: Ten sequence types were identified, including ST235, ST244, ST773, and ST1047, indicating high clonal diversity rather than a single outbreak lineage. All isolates were non-susceptible to ciprofloxacin, ceftazidime, piperacillin–tazobactam, and aztreonam; 5/13 were non-susceptible to ceftolozane–tazobactam and 4/13 were meropenem-resistant. Carbapenemase-positive isolates carried bla IMP-1 (3/13) or bla NDM-1 (1/13). Resistance-associated chromosomal variation affected porins, efflux regulators, and β-lactam response pathways. Virulence profiles were heterogeneous, with mutually exclusive exoU (7/13) or exoS (6/13) carriage and variable pyocyanin and rhamnolipid production. Conclusions: These data provide genomic and phenotypic characterisations of combat-wound P. aeruginosa from Ukraine, highlighting substantial diversity and frequent multidrug-resistant phenotypes and supporting lineage-resolved genomic surveillance in conflict-associated care pathways.
Background: The geographic distribution of Aedes aegypti and dengue virus (DENV) is expanding into high-altitude, historically non-endemic ecosystems across Latin America. This scoping review synthesizes evidence on the ecological limits, thermal thresholds, and socio-environmental drivers that govern this altitudinal expansion. Methods: Following Joanna Briggs Institute (JBI) methodology and PRISMA-ScR guidelines, a systematic search was conducted across PubMed, Scopus, LILACS, and Web of Science through February 2026. Evidence was extracted from 28 eligible studies evaluating vector establishment, viral circulation, and environmental predictors across elevation gradients. Results: Synthesis confirms that Ae. aegypti has breached the historical ecological barrier of 1500 m above sea level (m.a.s.l.). Larval infestation and autochthonous viral transmission are documented above 2000 m.a.s.l., reaching established limits of 2550 m.a.s.l., with oviposition recorded up to 2900 m.a.s.l. Colonization is driven by thermal anomalies linked to El Niño-Southern Oscillation (ENSO) events, coupled with rapid urbanization and intermittent municipal water supply. Conclusions: Topographies below 2500 m.a.s.l. no longer provide natural insulation against vector establishment. Public health frameworks must transition toward predictive microclimatic vector surveillance in mountain communities.
