Temporal dynamics of infectious agents and antimicrobial resistance in burn unit patients: experience from a five-year surveillance

Burn patients are highly susceptible to infections due to disruption of the skin barrier, and prolonged hospital stays. This study aimed to describe the microbial landscape and antimicrobial resistance patterns in burn unit and to identify clinical predictors of mortality.
We retrospectively analyzed 743 culture-positive specimens from 200 patients hospitalized between 2020 and 2024. clinical characteristics, and microbiological findings, were evaluated. Antimicrobial susceptibility testing was performed using automated systems and interpreted according to (EUCAST) standards. Logistic regression was applied to determine factors associated with in-hospital mortality.
The cohort was predominantly male (70%), with a median age of 42.5 years (IQR 30–60). Flame burns were the leading cause (58%), and ≥20% total body surface area (TBSA) involvement was observed in 63%. Overall mortality was 33.5%, and was independently associated with male sex, age ≥66 years, full-thickness burns, TBSA ≥20%, and hospitalization < 1 month (p < 0.05). Pseudomonas aeruginosa and Acinetobacter baumannii were the most frequent gram-negative pathogens. Methicillin-resistant Staphylococcus aureus constituted a large proportion of gram-positive isolates.
This five-year assessment underscores the substantial burden of multidrug-resistant organisms in burn units. The findings highlight the importance of unit-specific antibiograms, robust infection prevention measures, and strengthened antimicrobial stewardship to optimize outcomes in this high-risk population.