Healthcare-Associated Infections Characteristics Among Burn Patients Admitted to a Tertiary Hospital in West India

Background: Healthcare-associated infections (HAIs) are a major cause of morbidity and mortality among burn patients due to compromised skin barriers and immunosuppression. This study characterizes HAIs in burn patients admitted to a tertiary care hospital in West India. Methods: A prospective observational study was conducted from January 2023 to December 2024 at tertiary care Hospital, in western India, involving 250 consecutive burn patients. Surveillance followed CDC definitions for HAIs. Microbiological cultures from wound swabs, blood, urine, and sputum were analysed. Data on demographics, burn characteristics, infection types, pathogens, and outcomes were collected. Results: Of 250 patients (mean age 32.4 ± 15.2 years; 58% male), 68 (27.2%) developed 85 HAIs (incidence density: 22.4 per 1,000 patient-days). Burn wound infections (BWIs) were most common (52.9%), followed by bloodstream infections (BSIs; 23.5%), urinary tract infections (UTIs; 11.8%), and pneumonia (11.8%). Key pathogens included Pseudomonas aeruginosa (42.4%), Staphylococcus aureus (18.2%), Acinetobacter baumannii (15.2%), and Klebsiella pneumoniae (9.1%). Multidrug-resistant organisms predominated (65.2%). Risk factors included total body surface area (TBSA) burned >30% (OR 3.2, 95% CI 1.8-5.7) and mechanical ventilation (OR 4.1, 95% CI 2.1-8.0). Mortality was 14.7% overall, rising to 32.4% in HAI cases. Conclusion: HAIs, predominantly BWIs caused by Gram-negative bacteria, pose a significant burden in West Indian burn units. Enhanced surveillance and antimicrobial stewardship are essential.