Infection Management in Burn Care

Burn injury disrupts the skin’s primary protective barrier, exposing underlying tissues to a diverse microbial milieu and creating a niche for rapid colonisation and infection. Management begins with accurate assessment of the burn depth and total body surface area affected, which correlate closely with infection risk and guide both topical and systemic prophylactic strategies. Early excision and grafting reduce bacterial load, while stringent wound-care protocols and surveillance cultures inform targeted antimicrobial therapy. The rise of multidrug-resistant organisms, particularly Gram-negative bacilli and methicillin-resistant Staphylococcus aureus, has driven research into alternative approaches, including novel topical agents, local antimicrobial dressings and anti-biofilm therapies. Prompt recognition of systemic signs of infection and sepsis, supported by emerging biomarkers, allows timely haemodynamic support and antimicrobial stewardship. Integration of advanced diagnostics, robust infection-control practices and personalised treatment regimens has led to improved survival rates and shorter hospital stays, even in low-resource settings. Collaborative efforts spanning microbiology, surgical care and critical care continue to refine global guidelines and foster innovations in burn-wound infection prevention and treatment.

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Infection Management in Burn Care publication trend

The graph below shows the total number of articles in infection management in burn care across all publications each year (not limited to Nature Index journals).

Technical terms

Total body surface area (TBSA): The percentage of the patient’s skin affected by burns; a key metric for infection risk and fluid resuscitation.

Burn wound infection: Colonisation of a burn wound by pathogenic microorganisms leading to local tissue damage and delayed healing.

Bloodstream infection (BSI): The invasion of the bloodstream by bacteria or fungi from a primary infection site, often resulting in sepsis.

Sepsis: Life-threatening organ dysfunction caused by a dysregulated host response to infection, requiring prompt diagnosis and treatment.

Multidrug-resistant organism (MDRO): A microorganism resistant to three or more antimicrobial classes, complicating treatment choices.

Biofilm: A structured community of microorganisms encased in a self-produced matrix; biofilms on burn wounds impede antimicrobial penetration and immune clearance.

References

1. Gram-Negative Bacilli Blood Stream Infection in Patients with Severe Burns: Microbiological and Clinical Evidence from a 9-Year Cohort. International Journal of Molecular Sciences (2024).
2. Risk Factors and Pathogens of Wound Infection in Burn Inpatients from East China. Antibiotics (2023).
3. The pathogenesis and diagnosis of sepsis post burn injury. Burns & Trauma (2021).
4. Burns and biofilms: priority pathogens and in vivo models. npj Biofilms and Microbiomes (2021).
5. Epidemiology and outcomes of bloodstream infections in severe burn patients: a six-year retrospective study. Antimicrobial Resistance & Infection Control (2021).