Incidence and Risk Factors Associated with Microbial Colonization of Burn Wounds: An Observational Study

Abstract

Background: Microbial colonization of burn wounds leads to infection, which is a major cause of morbidity/mortality, prolonged admission, and cost. This study aims to investigate the incidence of positive burn wound colonization and its associated risk factors in a provincial referral center within a single-payer system. Methods: We performed a retrospective review of all adult (≥18 years) patients admitted to a single, tertiary burn center, with a primary burn diagnosis between January 2011 and 2021. Microbiology records were screened to identify patients with culture-positive burn wounds. Univariable and multivariable logistic regression analyses were used to evaluate risk factors associated with burn site colonization. Results: The sample included N = 634 participants. Most were male (72.1%), with a flame injury (62%), and had a mean age of 47.6 (±18.0) years and a TBSA of 13.5% (±14.8). The incidence of positive burn wound colonization was 27.3%. Increasing participant age, diabetic status, larger burn TBSA, presence of full-thickness burns, inhalation injury, and lower limb and trunk involvement were associated with statistically significant ( P ≤ .05) increased odds of a positive burn wound culture. Conclusion: This study provides an estimate of the incidence of primary burn wound colonization at a single, tertiary care, burn center as well as identifies potential risk factors associated with this outcome. Clinicians should consider closely monitoring patients with these risk factors for possible progression to clinical burn site infection. Future research should address strategies to mitigate colonization in patients with identified risk factors.