Skopje, 19 March 2025 (ECDC/MIA) - The European Centre for Disease Prevention and Control (ECDC) is closely monitoring the situation following the tragic fire at the Pulse nightclub in Kochani, North Macedonia. Many patients with burn injuries are being transferred to hospitals across EU Member States and neighbouring countries for urgent medical care.

ECDC is highlighting the risk of severe infections in patients with burn injuries from the North Macedonia fire caused by bacteria resistant to carbapenems, a last-line group of antibiotics. Burn wounds are often colonised by gram-negative bacteria, such as Pseudomonas aeruginosa, Acinetobacter spp. and Enterobacterales, including Klebsiella pneumoniae; which are often resistant to multiple antibiotics, including carbapenems, and which can spread in healthcare settings. Carbapenem-resistant (CR) bacteria pose a serious threat to patient safety as infections caused by them can be very difficult to treat.

Data from North Macedonia in 2023 indicate a high incidence of CR bacteria. The transfer of patients across borders, while necessary, can also lead to the spread of CR bacteria. A similar nightclub fire in Bucharest, Romania, in 2015, saw burn victims developing serious CR bacterial infections, underscoring this risk.

ECDC recommends hospitals receiving patients from North Macedonia implement precautions to prevent the potential spread of CR bacteria. These include isolating patients in single rooms immediately upon admission or grouping such patients, screening for multidrug-resistant bacteria including CR bacteria, ensuring strict hand hygiene and environmental cleaning, and using antibiotics judiciously.

Ensuring those injured in the fire receive the best care is extremely important, alongside vigilance regarding public health risks antibiotic resistance. Healthcare systems taking appropriate precautions can help protect patients. ECDC encourages countries to share information on any CR bacteria cases found in transferred patients to support a coordinated response.

The rise of multidrug-resistant bacteria, including CR bacteria, is a growing public health threat in Europe, and ECDC is actively working to address it.

MIA file photo