Bacteriological Profile and Antibiotic Sensitivity Pattern of Burn Wounds in a Tertiary Burn Care Center

Background: Burn wounds provide a favorable environment for opportunistic pathogens, leading to microbial colonization, infection-related complications, prolonged hospitalization, and increased morbidity, particularly in low- and middle-income countries. Understanding the bacteriological profile and antibiotic sensitivity is essential for guiding therapy and curbing inappropriate antibiotic use. Therefore, this study aimed to determine the bacteriological profile of burn wounds and assess antimicrobial sensitivity on the 1st, 5th, and 10th post-burn days in a tertiary burn care center. Materials and methods: A prospective observational study was conducted at National Institute of Burn and Plastic Surgery (NIBPS), Dhaka, Bangladesh, from July 2022 to December 2023. A total of 110 patients with burns involving 10-50% of total body surface area were enrolled and followed longitudinally. Wound swabs were collected from the same patients on the first, fifth, and 10th post-burn days to assess the early, intermediate, and later phases of bacterial colonization and antimicrobial susceptibility changes over time. Isolates were identified by standard microbiological techniques, and antibiotic susceptibility testing was performed using the CLSI disc diffusion method. Results: Children under 10 years constituted the largest proportion of cases (43.6%). Flame burns predominated (50%), with the trunk most commonly affected (73.6%). Bacterial growth increased from 36.4% on day 1 to 86.4% by day 5 and remained high on day 10. Gram-negative organisms predominated throughout the study period, with Pseudomonas aeruginosa being the most frequent isolate. None of the tested antibiotics demonstrated consistently high susceptibility. Colistin demonstrated comparatively higher susceptibility than other tested antibiotics, although susceptibility rates remained suboptimal. Conclusion: Burn wounds showed rapid colonization predominantly by gram-negative organisms, particularly Pseudomonas aeruginosa, with low antibiotic susceptibility across several commonly used agents. The findings highlight the potential importance of continuous microbiological surveillance, burn unit-specific antibiograms, antimicrobial stewardship, and rational antibiotic use in burn care settings.