Prevalence of hospital-acquired infections in burn patients: A six-year experience from northern Iran

Burn injuries represent a major public health problem, particularly in low- and middle-income countries, where hospital-acquired infections (HAIs) are one of the leading cause of morbidity and mortality. Burn patients are especially vulnerable due to loss of skin barrier, immune suppression, prolonged hospitalization, and invasive procedures. Therefore, this study aimed to determine the six years prevalence of HAIs in burn patients admitted to a subspecialty center for burn accidents. A retrospective cross-sectional study was conducted at Velayat Hospital, Rasht, northern Iran, including all burn patients admitted between March 2018 and March 2023 with hospital stays longer than 48 hours. Demographic, clinical, microbiological, and outcome data were extracted from hospital records. A total of 1,098 HAIs were documented, corresponding to a prevalence of 3.7%. The mean age of infected patients was 39.4 ± 20.7 years, and 74.1% were male. Skin and soft tissue infections were most frequent (89%), followed by ventilator-associated pneumonia (VAP) (5%), bloodstream infections (4.1%), and urinary tract infections (1.5%). Pseudomonas spp. (33.1%) and Klebsiella spp. (14.1%) were the leading pathogens. Mortality occurred in 29% of infected patients, with the highest rate among VAP cases (80%). Higher TBSA burns (>30%) and older age were significantly associated with mortality. HAIs remain a serious complication among burn patients, with Pseudomonas spp. as the predominant pathogen and VAP as the leading risk factor of death. Targeted infection-control strategies, improved microbiological diagnostics, and focused interventions for high-TBSA patients are critical to improving outcomes in burn centers.