Bacterial and Antimicrobial Susceptibility Persistence Pattern and Prevalence of Sepsis Among Burn Patients

Background: Infection is a major cause of mortality and morbidity among burn patients. Clinical diagnosis of bacteremia and/or sepsis in burn patients could be symptomatic and/or asymptomatic as a result of immune deficiency secondary to thermal injury. Accordingly, this study sought to characterize the microbial landscape, antibiotic susceptibility profiles, and sepsis incidence in burn patients. Methods: This analytical cross-sectional study was performed on pediatric patients hospitalized in Imam Khomeini Hospital, Urmia, Iran, from October 2021 to September 2022. The subjects included 515 burn patients (1–85 years old) exhibiting symptoms suggestive of sepsis, aligned with the latest American Heart Association guidelines. Their blood samples were cultured, and antimicrobial susceptibility testing was conducted by the Kirby-Bauer disc diffusion technique. The required data were collected by pre-tested questionnaires to identify potential septicemia-associated factors. Results: The mean age (standard deviation) of burn patients was 27.7 (±19.62) with a minimum of 1 year and a maximum of 85 years. Approximately 66.9% of patients were male, and the remaining 33.1% were female. Wound cultures were taken from 24 patients, and 16 (66.7%) were positive. Acinetobacter baumannii (29.2%) was the most common microorganism in wound culture. Resistance to co-trimoxazole and cefotaxime was 66.7% and 54.2%, respectively. Blood cultures were taken from 39 cases, and 10 (25.6%) were positive. The rate of sepsis was 1.94%. The most common bacterium isolated from blood culture was A. baumannii (10.3%), and resistance to gentamicin and cotrimoxazole was 23.1% and 15.4%, respectively. Conclusion: Among the Gram-negative bacteria, A. baumannii was resistant to most antibiotics in the blood and wound culture and was the predominant isolate. Resistance to cotrimoxazole, cefotaxime, and gentamicin had a high frequency. It was revealed that an increase in burning percent leads to sepsis and increases the mortality rate.