Impact of biofilm-forming ability and multidrug resistance on clinical outcomes of burn wound infections caused by Pseudomonas aeruginosa
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Abstract
Burn wound infections caused by Pseudomonas aeruginosa represent a major clinical challenge due to the pathogen’s virulence, biofilm-forming capacity, and increasing multidrug resistance (MDR). These factors may adversely affect treatment efficacy and patient outcomes in burn units; however, their combined clinical impact remains insufficiently characterized in hospital-based settings. This study aimed to evaluate the association between biofilm-forming ability, MDR, and clinical outcomes in burn wound infections caused by P. aeruginosa. In this cross-sectional study, 30 non-duplicate P. aeruginosa isolates were obtained from hospitalized burn patients at a tertiary care burn center between March 2022 and March 2023. Bacterial identification was performed using standard microbiological methods. MDR was defined as resistance to at least one agent in three or more antimicrobial classes. Biofilm formation was assessed using the microtiter plate assay. Among the 30 patients, 76.7% were male, and the mean age was 45.8 ± 16.9 years. The mean total body surface area (TBSA) was 42.9% ± 20%. Fifteen isolates (50%) were classified as MDR. Biofilm assessment revealed that 40% of isolates were strong biofilm producers, 16.7% moderate, and 43.3% weak producers. No statistically significant associations were identified between biofilm strength, MDR status, TBSA, and clinical outcomes. P. aeruginosa burn wound infections were characterized by a high prevalence of biofilm formation and MDR. While no significant associations with mortality were demonstrated, trends toward poorer outcomes in patients infected with strong biofilm-producing and MDR isolates underscore the clinical relevance of these traits. Larger studies incorporating molecular analyses are warranted to clarify their prognostic significance.
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