The spread of multidrug-resistant microorganisms remains a major global challenge that continues to worsen. Modern military conflicts intensify this problem by forcing healthcare systems to manage large numbers of patients with complex, heavily contaminated injuries in resource-limited settings. This can disrupt infection prevention and control and promote the emergence and spread of resistant pathogens. In this context, antiseptics are essential in combat wound management and should be used throughout patient care, from first aid to rehabilitation. Among them, active chlorine compounds deserve special attention because of their broad-spectrum, rapid microbicidal action, minimal risk of resistance development, good tolerability, and affordability. This review summarizes recent advances in their use for wounds of various origins. Active chlorine preparations are highly effective against microorganisms that commonly complicate acute and chronic wounds, including multidrug-resistant and biofilm-forming pathogens. In addition, their anti-inflammatory, reparative, and immunomodulatory properties may accelerate healing through multiple mechanisms while maintaining low toxicity. The broad range of formulations, from traditional hypochlorous acid solutions to polymers with N-Cl moieties and wearable electrochemical dressings, supports use in both field and hospital settings. Together, these features make active chlorine products promising non-antibiotic tools for modern wound infection control, particularly in military medicine.

Objectives:Rising antimicrobial resistance (AMR) in Escherichia coli urinary tract infections (UTI) poses a global challenge. Evidence-based treatment of cystitis requires local resistance data. The DASH to Protect Antibiotics (https://dashuti.com/), a multi-regional group, supports centers in generating and sharing focused antibiograms to guide stewardship in community UTIs. This multi-country study aimed to describe antimicrobial susceptibility patterns of community-acquired E. coli isolates in low, middle, and high-income countries (LMICs and HICs). Methods:The study was conducted in 37 representative centers across 13 countries in Asia (Middle East and Indian Subcontinent), Africa, Europe, and North America. A rigorous comparative analysis of the antimicrobial susceptibility of E. coli isolated from cases of simple cystitis presenting in outpatient or emergency departments was carried out. The impact of gross domestic product, climate, and population density per km2 on E. coli susceptibility profile was analyzed using the Kruskal-Wallis test and two-way analysis of variance. Results:Antimicrobial susceptibility varied significantly between LMICs and HICs, with nitrofurantoin (89%) and fosfomycin (96%) emerging as empiric choices globally. Across most centers, susceptibility to other oral antimicrobials was low: co-trimoxazole <60%, amoxicillin-clavulanic acid <70%, first-generation cephalosporins <50%, fluoroquinolones <60%. Injectable antibiotics fared better: piperacillin-tazobactam >70%, amikacin and meropenem >80%. Higher susceptibilities were noted in countries with high gross domestic product (P < 0.001) and humidity (P = 0.002). Conclusion:Marked geographical differences in E. coli susceptibility patterns support the need for localized antibiograms and tailored empirical therapy. This study reinforces the utility of nitrofurantoin and fosfomycin as first-line agents and discourages the use of fluoroquinolones and third-generation cephalosporins.

Chronic infections in cystic fibrosis (CF) patients are often driven by adaptive and drug-resistant bacterial lineages. Understanding sequence types (STs) and phenotypic adaptations such as small colony variants (SCVs) can guide more effective clinical management. Seventeen bacterial isolates from respiratory specimens of 12 pediatric CF patients (Dnipro, Ukraine, Sept 2022–Sept 2024) were characterized via culture-based diagnostics and whole genome sequencing (WGS). Multi-Locus Sequence Typing (MLST) was applied to determine sequence types, while phenotypic traits, including SCV morphology, were recorded and antimicrobial resistance (AMR) genes profiled. The collection included Staphylococcus aureus (n = 8), Pseudomonas aeruginosa (n = 5), Serratia marcescens (n = 2), Enterobacter hormaechei (n = 1), and Klebsiella pneumoniae (n = 1). SCV phenotypes were observed in 2 S. aureus ST398 isolates. P. aeruginosa strains belonged to diverse STs (ST644, ST2967, ST1228, ST242). The hypervirulent K. pneumoniae ST23-KL1 isolate harbored siderophores (iucA, ybt) and peg-344. All S. aureus ST398 isolates exhibited reduced growth rate and dense colony morphology. This study highlights the genetic and phenotypic complexity of respiratory pathogens in Ukrainian CF children, emphasizing the emergence of ST398 SCVs and the introduction of hypervirulent K. pneumoniae lineages. The findings call for regular genomic surveillance in Ukrainian CF cohorts.

In light of the deterioration of microbiological composition of natural and technical water, the development of new approaches to its disinfection is an important technological task. The use of chlorine-active compounds remains the most effective for this purpose, but traditional preparations such as sodium hypochlorite pose a number of environmental risks. This paper describes the processes of treating model microbiologically contaminated solutions with granular styrene-divinylbenzene polymers with immobilized N-chlorosulfonamide groups. In this case, chlorine is released from the polymer surface into the solution due to chlorination of the amine components of the microbial cell. The amount of chlorine released is proportional to the degree of microbial contamination. The main factors influencing the disinfection rate and the characteristics of the chlorine emission process are the intensity of stirring, the type and concentration of the microorganism, and the surface area of the polymer. The treatment is effective against individual Gram-positive and Gram-negative bacteria, including multi-resistant ones, fungi, and multi-culture natural media. The use of this method for water disinfection potentially allows avoiding chlorine overdose, minimizing the formation of toxic chlorine-containing by-products, and ensuring long-term protection of water from re-contamination during storage.

Solutions of N-chlorotaurine (NCT) are effective microbiocidal agents with a broad spectrum of pharmacological activity and outstanding tolerability. The main problem limiting their medical use is their instability, which is generally inherent in solutions of all chlorine-active compounds. In this work, we developed a new synthetic approach to the synthesis of such solutions, which consists in the activation of granular and fibrous polymeric materials with immobilized N-chlorosulfonamide groups, which act here as a chlorinating agent. It was shown that when such polymers are added to taurine solutions, NCT solutions with a chemical composition suitable for immediate medical use can be obtained. The stability of such solutions under various conditions was analyzed in comparison with NCTs obtained by the classical method from sodium hypochlorite. It was confirmed that the process of decomposition of all studied solutions obeys the kinetic laws of the first-order reaction. It was proven that solutions obtained from granular polymers are more stable both in terms of active chlorine concentration and in terms of pH, and their additional buffering is not needed. The stability of solutions decreases when they are stored in the presence of polymers used, with an increase in the excess of taurine and with acidification. The high sensitivity of all obtained solutions to UV radiation was also noted. The antimicrobial properties of NCT solutions obtained from polymers are not inferior to those obtained from sodium hypochlorite at the same concentration of active chlorine. Considering the stability and compactness of the initial chlorine-active polymers, as well as the possibility of their multiple regeneration, the developed method can form the basis of the technology for obtaining multifunctional NCT solutions for medical purposes with the desired physical and chemical properties without using special equipment or specific reagents.

Background: While mapping Escherichia coli susceptibility in community acquired simple UTIs across 38 centres, DASH to Protect Antibiotics, (https://dashuti.com/), a multiregional study also assessed impact of socio-economic conditions and climate on antimicrobial susceptibility. Methods: The centres were located in the Indian subcontinent, Middle East, North and West Africa, Eurasia, Europe, and North America. Harmonic means were used for comparative analysis of the antimicrobial susceptibility of E. coli in simple cystitis. Kruskal-Wallis test was utilized to compare susceptibility means between the antimicrobials and the GDP. A two-way ANOVA to simultaneously analyzed the impact of the antimicrobials and GDP on the proportion of susceptible E. coli while adjusting for variables (low and high temperature, humidity and population density per sqkm). Findings: Antimicrobial susceptibility varied between regions and within large countries like India and Pakistan. Nitrofurantoin (89%) and fosfomycin (96%) emerged as the most effective antimicrobials. In majority of the centres, susceptibility to other oral antimicrobials was low: cotrimoxazole.

Polymer materials with immobilized functional groups-donors of active chlorine are widely used to create products with a microbiocidal effect and increased resistance to microbial contamination. In this work, various methods for the synthesis of granular styrene-divinylbenzene polymers with N-chlorosulfonamide groups were investigated. It has been shown that the synthesis of polymers with chlorine-active -SO2NNaCl groups from a non-functionalized styrene-divinylbenzene polymer matrix through the stage of its sulfochlorination with chlorosulfonic acid in dichloromethane for 6-7 h is optimal. These products contain approximately 11% of active chlorine and maintain a stable particle size distribution. When cation exchangers such as Purolite C100 are used as the initial polymer carrier, the content of chlorine-active groups in the target product is approximately 9%, and an increase in the content of the dust fraction is observed. The obtained samples, regardless of the synthesis method, are capable of releasing active chlorine into solutions containing amino compounds. The microbial impurities in water also cause the emission of active chlorine in an amount that does not depend on the loading of the polymer, but is determined by the concentration of microbes, due to which a pronounced antimicrobial effect is observed. In this case, the resulting products do not cause further decomposition of the functional groups of the polymer, which indicates the high service life of the latter. The availability of raw materials, relative ease of synthesis, stability, possibility of regeneration and microbiocidal properties of the studied polymers make them promising for use as components of water and air purification systems and other products for medical and industrial purposes. (c) 2024 Society of Chemical Industry.

Objectives:To better understand the source and potential transmission routes of antibiotic-resistant bacteria infecting injured service members in Ukraine.Methods:Phenotypic and genomic characterizations were performed on 11 Gram-negative pathogens cultured from war wounds at an intermediate evacuation hospital in Dnipro.Results:The analysis revealed both susceptible and extensively drug-resistant strains present in cultures, including high-risk global clones carrying carbapenemases.Conclusions:Globally distributed carbapenemase-producing lineages are being acquired early in the medical evacuation process.

OBJECTIVE:The aim: To describe microbiological features of the Staphylococcus spp. involved in complications of dental implantation.PATIENTS AND METHODS:Materials and methods: The main method was bacteriological. Indentification of the obtained isolates was done using commercially available test kits. Adhesive properties were evaluated using Brillis technique. Biofilm-forming ability was studied according to Christensen et al. Antimicrobial susceptibility testing was done following EUCAST recomendations.RESULTS:Results: There were 26 smears taken from the peri-implant area and gingival pockets of 12 patients. We obtained 38 isolates. Most of the patients were positive for Streptococcus spp. - 94% and Staphylococcus spp. - 90%. Among the representatives of Staphylococcus spp., the initial share of clinical isolates was S. aureus (34.21%) with inherent coagulase-positive properties. Coagulase-negative pathogens accounted for 65.79% of Staphylococcus spp., among them S. epidermidis, S. hominis, S. warneri were the main. All obtained isolates had typical properties, but appearance of small colonial variants of S. aureus was also recorded. Antimicrobial susceptibility testing was performed in 100% of cases. Among 13 isolates of S. aureus there were 2 cultures resistant to cefoxitin, i. e. methicillin-resistant by phenotype. Clinical isolates of S. aureus, colonizing peri-implant tissues in infectious-inflammatory complications of dental implantation, also had high adhesive and biofilm-forming properties. Clinical isolates of S. epidermidis an average ability to form biofilms.CONCLUSION:Conclusions: There is a prooved direct correlation between biofilm-forming ability and adhesive properties in highly biofilm-forming clinical isolates involved in the occurrence of purulent-inflammatory complications in peri-implant site.

The increase in the frequency and scale of epidemics of infectious diseases gives extreme urgency to the development of new technologies for antiseptic and disinfectant treatment of various media, as well as materials/reagents for their implementation. Antimicrobial polymer materials of various chemical structures, including those containing halogen-active functional groups, are promising in this regard. This work is devoted to the synthesis and investigation of the properties of granular and fibrous polymer materials with immobilized N-bromosulfonamide groups of different structure. It is shown that copolymers of styrene with divinylbenzene and polypropylene can be used as a carrier polymer. A technique has been developed that allows obtaining polymers with a content of up to 23 % of immobilized active bromine. The compliance of the synthesized materials with the declared structure has been proven by IR spectroscopy and a complex of chemical methods. A decrease in the strength of the obtained polymers compared to the original carriers has been observed, especially in the case of fibers. The stability of the synthesized polymers during storage is lower that of the previously described chlorine-active analogs. For the quantitative determination of active bromine in the target materials, a technique based on its rapid diffusion from the polymer into the taurine solution has been developed. Microbiological research has shown that the synthesized polymers have a pronounced antimicrobial activity, which is higher than that of immobilized N-chlorosulfonamides and is manifested even in the presence of a significant organic load. The set of investigated characteristics of synthesized polymers with immobilized N-bromosulfonamide groups suggests the prospect of their use as components of antiseptic dressing materials, antimicrobial filters, devices for obtaining antiseptic solutions, and other medical products

Introduction: Microorganisms colonizing the surface of dental implants can form biofilms that protect their microcolonies from mechanical impact, antimicrobial compounds, and immune factors. Prophylactic use of antibiotics during dental implantation can exert selective pressure on the development of antimicrobial resistance. In this context, N-chlorotaurine (NCT) is a promising compound to combat resistant agents. The aim is to investigate the efficacy of NCT against pathogens associated with dental implant complications. Materials and methods. A buffered 1% NCT solution adjusted to pH 7.1 was used for the study. Multidrug-resistant cultures (MDR) were identified. Determination of NCT activity was carried out by the agar and suspension method. The results. After standard antibiotic susceptibility testing, cultures classified as MDR were selected. 12 cultures were included in the MDR group, including seven S. aureus, three K. pneumoniae and three A. baumannii. MDR cultures of S. aureus had MRSA profile. Production of carbapenemases was confirmed in all MDR K. pneumoniae isolates, 2 of them showed production of metallo-β-lactamases. MDR isolates A. baumannii were also producers of metallo-β-lactamases. All 12 investigated MDR cultures were sensitive to NCT, the diameter of the zones of growth retardation was at least 15 mm. No significant difference was found between the effectiveness of 1% NCT solution against microorganisms with different mechanisms of drug resistance (t-test, p>0.05). When conducting studies in a liquid environment, a 1% NCT solution showed similar results, all MDR cultures were sensitive and showed a decrease in the microbial load (CFU/ml) by at least 2 log10 steps already 15 minutes after the start of the study. Notably, there was no significant difference in the efficacy of NCT against conditionally susceptible and MDR agents. Conclusions. Reducing the threat and burden of MDR pathogens is one of the goals announced by WHO and the Centres for Disease Control. Our study clearly confirms that various antibiotic resistance mechanisms do not affect the bactericidal activity of NCT, making it promising for the treatment of resistant infections.

The aim of the work was to evaluate the antimicrobial activity of polymeric materials with immobilized N-Chlorosulfonamide groups against multidrug-resistant hospital strains of common microorganisms and to determine the resistance to microbial penetration of these materials. Materials and methods: the studied samples were copolymers of styrene with divinylbenzene in the form of staple fibre and non-woven fabric with immobilized N-Chlorosulfonamide groups of various structures. Hospital strains of microorganisms have been isolated from clinical material; their antibiotic sensitivity has been determined by the Kirby-Bauer method. The agar diffusion method determines the antimicrobial activity of the polymers. Resistance to microbial penetration of samples of non-woven fabric has been determined by the membrane filtration method. Results: polymer samples have been synthesized with immobilized N-Chlorosulfonamide groups in the Na- and H-forms, and with the N, N-dichlorosulfonamide group, with chlorine concentration range 3.7 - 12.5 %. All samples demonstrated pronounced antimicrobial activity against both standard and hospital strains. Due to the higher specific surface area, staple fibre is generally more efficient. An increase in the zone of inhibition of the growth of microorganisms was observed with an increase in the concentration of immobilized chlorine. All the studied fabric samples are impermeable to S. aureus. The control samples containing the free sulfonamide group did not show antimicrobial properties. Conclusions: synthesized chlorine-active polymers have a pronounced antimicrobial activity against multidrug-resistant microorganisms, demonstrate high resistance to microbial penetration and therefore are promising for creating a wide range of medical products on their basis: dressings, protective masks, antimicrobial filters, etc.

The study aimed to assess the regional peculiarities of the respiratory profile of children with cystic fibrosis (CF) in the Dnipro region (Ukraine). Methods. Children living in the Dnipro region and aged younger than 18 years old with molecular-genetic confirmation of CF were enrolled in the study. Lung colonization was evaluated using a culture-dependent method. Sputum, mucus from the posterior pharyngeal wall and bronchoalveolar lavage fluid (BALF) were utilized. Results. The Firmicutes phylum was the most common and occupied 54.00 % of the general proportion. On the other hand, the Proteobacteria phylum demonstrated overexpression in CF airways and kept the second rank with 28.87 %. Sorensen's species similarity coefficient showed an allied affinity between the microbial burden of oropharyngeal samples with nasopharyngeal and sputum, QS = 0.61 and 0.91, respectively. However, the species composition within the nasal cavity was distinct from sputum and BALF (QS=0.47). The primary pathogens in childhood were S. aureus, H. influenza, P. aeruginosa and A. fumigatus. In contrast to gram-negative non-fermenters (GNNF), the prevalence of S. aureus isolates by age had a non-linear character. The commensal microbiota changed negatively with age. Among children under 12 years, the Streptococcus genus was identified in 23.08 % of the samples, but among the age category older than 15 – only in 9.22 %. 11.06 % of S. aureus had small colony variants (SCVs) morphotypes. Isolates of P. aeruginosa with the properties of SCVs were also found in children who underwent prolonged antimicrobial treatment. However, the most prominent was the mucoid phenotype – 34.31 % of isolates. Conclusions. Along with conventional microbiological properties, obligate pathobionts in children with CF exhibited changes, resulting in difficulties in identification. These included auxotrophic modification into SCVs and mucoid transformation. The culture-dependent technique gives crucial data about the profile of pathogens usually associated with CF, although it is sufficiently limited

Objective: The objective was to determine the inhalation toxicity of the electrochemically generated sodium hypochlorite solution after its single administration to laboratory animals in the form of a highly dispersed aerosol. Materials and methods: The study has been conducted according to the OECD Test Guideline No403 'Acute Inhalation Toxicity.' Laboratory animals were exposed to inhalation of an aerosol containing 1.7 +/- 0.13 mg/m(3) of active chlorine. The hematological and biochemical parameters of the blood of experimental animals have been determined, as well as specific parameters: the activity of cathepsins B and L, catalase, and alpha 1-antitrypsin. Histological study of the lungs of animals has been carried out. Results: During inhalation and 14 days after it, no death of the animals was observed; the behavior, appearance, and weight gain did not differ from the control group. There were no significant deviations in hematological parameters, except the decrease in the level of platelets. The biochemical study showed slight changes in the activity of alkaline phosphatase and aspartate aminotransferase on the 1st day after inhalation; these parameters returned to normal within 14 days of observation. Specific biochemical parameters did not show the development of oxidative stress. No specific histological pathologies of lung tissue have been found. Conclusions: Thus, the studied electrochemically generated sodium hypochlorite solution under single inhalation exposure in aerosol form practically does not cause a toxic effect. The data obtained allow classifying such solution to the 4th (or even 5th - after additional studies) class of toxicity in accordance with Globally Harmonized System of Classification and Labeling of Chemicals.

Virucidal properties of N-chlorosulfonamides immobilized on fibrous styrene-divinylbenzene copolymers have been studied. Corresponding materials with different functional group structures and chlorine content have been synthesized on FIBAN polymer carriers in the form of staple fibers and non-woven fabrics. The study has been conducted in general accordance with EN 14476 standard on poliovirus type-1 and adenovirus type-5. It has been found that all tested samples exhibit pronounced virucidal activity: regardless of the carrier polymer form, sodium N-chlorosulfonamides inactivated both viruses in less than 30 s, and N,N-dichlorosulfonamides—in 30–60 s. The main mechanism of action of these materials, obviously, consists in the emission of active chlorine from the functional group into the treated medium under the action of the amino groups of virus fragments and cell culture. Considering the previously described antimicrobial and reparative properties of such materials, as well as their satisfactory physical and mechanical properties, the synthesized polymers are promising for the creation of medical devices with increased resistance to microbial contamination, such as protective masks, filter elements, long-acting wound dressings, and others.

The article considers two approaches to training in high medical school: 1) using English as a Medium of Instruction and 2) Content and Language Integrated Learning the emergence of which was related to a wide spread of bilingualism in society, importance of increase in competitiveness of graduates of domestic universities on international labor market. The authors present the models of teaching within the stated approaches which promote the efficiency of professional training of future doctors in solving professional problems on the basis of implementation of foreign language competence. The paper defines the conditions of content and language integrated models implementation into the learning process. In conclusion, it is noted that the integration of subject and language experience contributes to the optimization of foreign language training and significant improvement of the quality of the educational process. The most pressing issues requiring additional research are identified.

BACKGROUND: Cystic fibrosis (CF) is a genetic disorder with an autosomal-recessive type of inheritance. Based on their host-defending and pro-inflammatory functions, antimicrobial peptides (AMPs) likely have one of the central roles in the pathogenesis of lung disease in CF. AIM: The purpose of the study was to measure the concentration of AMPs in the sputum of children with CF and evaluate any correlation with a bacterial profile of the lungs. METHODS: Lung colonization was evaluated using a culture-dependent method, sputum was utilized. A sandwich-ELISA was used to measure hBD-2 and hCAP-18/LL-37 in the sputum. RESULTS: There were 27 children enrolled in the study group, median age of inclusion was 11.4 (8.5; 14.8) years old. The control group consisted of 14 children, 11.6 (8.6; 12.6) years old. The concentration of AMPs was not correlating with participants` age (rs = −0.286, p = 0.148 – defensin hDB-2; rs = −0.084, p = 0.676 – cathelicidin hCAP-18/LL-37). The concentration of hBD-2 was from 64.01 to 813.61 pg/mL. The concentration of hCAP-18/LL-37 was from 3.24 to 35.98 ng/mL. There were significant differences in the content of AMPs on respiratory samples between study and control group (U = 976.5, p = 0.001 – for hBD-2; U = 1080.5, p < 0.001). The correlation between current infection Pseudomonas aeruginosa and concentration of hBD-2 (rs = 0.167; p = 0.406) was not found. However, the presence of P. aeruginosa correlated with density of neutrophilic infiltration (rs = 0.622; p = 0.001). The concentration of hBD-2 showed direct medium correlation with total cells count (rs = 0.881, p < 0.001). Correlation between current infection P. aeruginosa and concentration of hCAP-18/LL-37 (rs = 0.788; p < 0.001) was observed. With increases in total cell count and relative neutrophils count, the concentration of hCAP-18/LL-37 was increased and the power of the association was medium (rs = 0.453; p = 0,018; rs = 0,592; p = 0,001). The correlation between concentrations of hBD-2 and hCAP-18/LL-37 (rs = 0.316, p > 0.1) was not found. CONCLUSIONS: Measured AMPs correlated with cellular inflammatory markers and, probably, their overexpression is dedicated to stimulating a cellular component of innate immune response; there was no correlation between bacterial colonization of lungs and levels of hBD-2, so our findings sustain that P. aeruginosa is a leading but non-single contributor to persistent local inflammation in polymicrobial lungs.

Introduction: There is evidence suggesting the existence local inflammation in the lungs prior to bacterial infection in cystic fibrosis (CF). The study was aimed to assess the relationship between the concentrations of hBD-2 and hCAP/LL-37 in sputum with bacterial colonization of lungs. Material and methods: Among 24 children with CF enrolled in the study, eight were diagnosed with chronic infection Pseudomonas aeruginosa. There were 10 previously health children with mild community-acquired pneumonia. Their sputum was collected by spontaneous expectoration. MacConkey agar was used for isolation of P. aeruginosa. The levels of hBD-2 and hCAP/LL-37 were measured using commercial test kits (Elabscience, USA), ELISA. The Microsoft Office Excel was used for statistical data processing; all levels of significance were set at p<.05. Results: There were 14 samples of the sputum. Mucosal antimicrobial peptides hBD-2 and LL-37 were present in the sputum of all children with CF. The median concentration of the hBD-2 was 236.47 (156.86; 669.21) μg/ml. The median concentration of LL-37 was 6.28 (4.02; 7.02) pg/ml. The concentration of LL-37 was increasing with elevated relative neutrophiles count in children with CF, rs = 0.57, p = 0.008. The increased levels of hBD-2 were associated with the presence of P. aeruginosa, rs = - 0.44, p = 0.043. There was a correlation between concentrations of hBD-2 and LL-37, rs = 0.515, p = 0.029. The concentration of hBD-2 in children with CF was lower than in previously healthy – 0.89 (0.83; 0.92), p = 0.012. Conclusions: The levels of mucosal peptides correlated with cellular markers of inflammation in sputum and microbiological profile of the airways.

The ongoing pandemic disaster of coronavirus erupted with the first confirmed cases in Wuhan, China, in December 2019, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) novel coronavirus, the disease referred to as coronavirus disease 2019, or COVID-19. The World Health Organization (WHO) confirmed the outbreak and determined it a global pandemic. The current pandemic has infected nearly 300 million people and killed over 3 million. The current COVID-19 pandemic is smashing every public health barrier, guardrail, and safety measure in underdeveloped and the most developed countries alike, with peaks and troughs across time. Greatly impacted are those regions experiencing conflict and war. Morbidity and mortality increase logarithmically for those communities at risk and that lack the ability to promote basic preventative measures. States around the globe struggle to unify responses, make gains on preparedness levels, identify and symptomatically treat positive cases, and labs across the globe frantically rollout various vaccines and effective surveillance and therapeutic mechanisms. The incidence and prevalence of COVID-19 may continue to increase globally as no unified disaster response is manifested and disinformation spreads. During this failure in response, virus variants are erupting at a dizzying pace. Ungoverned spaces where nonstate actors predominate and active war zones may become the next epicenter for COVID-19 fatality rates. As the incidence rates continue to rise, hospitals in North America and Europe exceed surge capacity, and immunity post infection struggles to be adequately described. The global threat in previously high-quality, robust infrastructure health-care systems in the most developed economies are failing the challenge posed by COVID-19; how will less-developed economies and those health-care infrastructures that are destroyed by war and conflict fare until adequate vaccine penetrance in these communities or adequate treatment are established? Ukraine and other states in the Black Sea Region are under threat and are exposed to armed Russian aggression against territorial sovereignty daily. Ukraine, where Russia has been waging war since 2014, faces this specific dual threat: disaster response to violence and a deadly infectious disease. To best serve biosurveillance, aid in pandemic disaster response, and bolster health security in Europe, across the North Atlantic Treaty Alliance (NATO) and Black Sea regions, increased NATO integration, across Ukraine's disaster response structures within the Ministries of Health, Defense, and Interior must be reinforced and expanded to mitigate the COVID-19 disaster.

The aim: To determine the prevalence rate of Staphylococcus aureus infection among children with Cystic Fibrosis in the Dnieper region, to provide microbiological characteristics of the isolates and to elevate their susceptibility to antimicrobials. Materials and methods: Sputum, tracheobronchial lavage waters and/ or deep smear from the posterior pharyngeal wall were taken from children with genetically confirmed Cystic Fibrosis. Bacteriological method was the main. The first screening for small colony variants of Staphylococcus aureus was carried out after 48 hours of incubation. The antimicrobials susceptibility testing was determined by disk-diffusion method according to the EUCAST 2019. Microsoft Office Excel 2010 was used for statistical data processing. Results: Twenty one children were enrolled in the survey. The culture of Staphylococcus spp. was obtained from all patients with 40.8% positive for Staphylococcus aureus. Small colony variants appeared with the prevalence rate 21.6% after 48 hours of incubation. The frequency of associations between Staphylococcus aureus with auxotroph phenotype with the presence of Pseudomonas aeruginosa was significantly higher than with wild-type group. The 3d-generation aminoglycosides, the 3d-generation fluoroquinolones, linezolid, rifampicin and tetracyclines showed the best antimicrobial activity, however, resistance to cefoxitin and gentamicin was significantly higher in auxotroph-modified group. Conclusions: Infection Staphylococcus aureus is common among children. The appearance of auxotrophs registered after treatment with aminoglycosides and/ or co-trimoxazole and co-infection Pseudomonas aeruginosa. Isolates of Staphylococcus aureus showed good chemotherapeutic sensitivity, but tendency in increasing resistance registered for auxotroph-modified phenotype.