Epidemiological Profile of Bacterial Infections in Burn Patients Over a Five-Year Period

Burn patients are highly susceptible to bacterial infections, which significantly increase morbidity and mortality. Destruction of skin barriers following burns creates an ideal environment for tissue colonization by pathogenic microorganisms.

The aim of our study is to establish the epidemiological profile of bacterial infections in burn patients hospitalized in the Burns and Plastic Surgery Department of the Mohamed V Military Teaching Hospital (HMIMV) in Rabat and to describe their sensitivity to antibiotics.

This retrospective study spanned five years, from October 1, 2017, to December 31, 2022. During this period, a total of 548 samples were obtained, of which 366 (66.78%) were positive, corresponding to isolates of 39 non-redundant bacterial strains identified in 188 patient samples. Among these patients, 123 (65.42%) were males and 65 (34.22%) were females, yielding a sex ratio of 1.89. The mean age of the patients was 47.1 years, with an age range of 9 to 89 years. Microbiological and demographic data were collected for analysis. Bacterial isolates were identified using conventional bacteriological methods, and their antibiotic susceptibility was tested according to EUCAST 2019 guidelines.

Of 548 samples, 406 (74.08%) skin burns, 74 (13.5%) blood cultures, 29 (5.29%) urine samples, and 27 (4.92%) central catheter samples were analyzed. Among the gram-negative, non-fermenting bacilli (GNB) bacilli, Pseudomonas sp. (n=92; 16.78%) were in the majority, with Pseudomonas aeruginosa accounting for 85 (92.39%) cases, while Acinetobacter sp. represented 78 (14.23%) cases, including 74 (94.87%) of Acinetobacter baumannii. Gram-positive bacteria were dominated by Staphylococcus sp. (n=123; 22.44%), including Staphylococcus aureus (n=60; 49.18%) and coagulase-negative Staphylococcus (n=63; 51.63%). Antibiotic resistance rates were particularly high among gram-negative bacteria, with resistance to carbapenems and cephalosporins being particularly alarming in Acinetobacter baumannii. Among gram-positive cocci, strains of Staphylococcus aureus showed moderate resistance to several antibiotics but remained susceptible to glycopeptides.

Non-fermentable gram-negative bacilli, particularly Pseudomonas and Acinetobacter species, are widespread in burn patients and show worrying levels of resistance to many antibiotics. These results underline the importance of judicious antibiotic management and rigorous infection control practices in burn care units.