Temporal dynamics of the burn wound microbiome and their resistance towards various antibiotics: A hospital-based observational study

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Abstract Background: Burn wounds are highly susceptible to bacterial infections due to compromised skin barriers, leading to significant morbidity and mortality. Multidrug-resistant (MDR) pathogens pose a major challenge in burn care, often complicating treatment outcomes. In India, the prevalence of MDR infections in burn patients is rising, necessitating continuous surveillance and infection control. Gender-based variations in infection patterns and resistance profiles remain underexplored. This study investigates bacterial infection prevalence, resistance patterns, and gender disparities among burn patients at SUM Hospital, Bhubaneswar, providing crucial insights for improving clinical management. Materials and Methods: This retrospective study analyzed data from 101 burn wound patients (60 males, 40 females) admitted to SUM Hospital, Bhubaneswar. Burn wound swabs were aseptically collected, cultured on standard microbiological media, and bacterial isolates were identified using biochemical tests and automated systems. Antibiotic susceptibility was assessed using the Kirby-Bauer disk diffusion method per CLSI guidelines, with MDR defined as resistance to three or more antibiotic classes. Data were analyzed to assess bacterial prevalence, resistance patterns, and gender disparities. Ethical approval was obtained, and patient confidentiality was maintained. Result: A total of 101 pus samples were collected from burn wounds, including 60 males and 41 females. The 31-40 age group had the highest sample count (25), with 16 males and 9 females. Acinetobacter baumannii cplx caused the most infections in females, while Klebsiella pneumoniae (MDR) was predominant in males. Twenty-eight different bacterial species were identified, with Acinetobacter baumannii (MDR), Pseudomonas aeruginosa (MDR), Klebsiella pneumoniae (MDR), and Acinetobacter baumannii cplx being the most frequent in both genders. Several bacteria, such as Burkholderia cepacia, Candida auris, and Providencia rettgeri, showed high resistance to multiple antibiotics. Escherichia coli displayed 72.41% resistance, while its MDR strain exhibited 88.88% resistance. Klebsiella pneumoniae and its MDR strain showed resistance rates of 86.95% and 94.44%, respectively. The findings underscore the prevalence of MDR bacterial infections in burn patients. Detailed data on bacterial infections and resistance patterns are presented in tables and figures. Conclusion: This study highlights the high prevalence of multidrug-resistant (MDR) bacterial infections among burn wound patients at SUM Hospital, with notable gender disparities in dominant pathogens. The findings underscore the urgent need for improved infection control measures and targeted treatment strategies. Continued surveillance of antibiotic resistance patterns is crucial for effective burn care management.