Global pooled evidence on microbial flora, antimicrobial resistance, and infection control in burn units

Background: Burn wound infections (BWIs) remain a major cause of morbidity, mortality, and increased healthcare costs.Their management is complicated by the dynamic microbial ecology of burn wounds and the global rise in antimicrobial resistance (AMR).A clear understanding of evolving epidemiology, microbial patterns, and infection-control outcomes is vital for improving burn-care strategies.Objectives: To synthesize global evidence on microbial distribution, resistance trends, and infection-control effectiveness in burn units, with emphasis on multidrug-resistant pathogens including Acinetobacter baumannii, Pseudomonas aeruginosa, and methicillin-resistant Staphylococcus aureus (MRSA). Materials and Methods:This meta-analysis integrates findings from 40 peer-reviewed studies (1992-2025) involving microbiological surveillance, epidemiological assessment, molecular resistance profiling, and evaluation of infection-control practices across diverse burn centres.Trends in AMR, intervention effectiveness, and conventional versus emerging infection-prevention approaches were comparatively assessed.Results: Pooled data identified P. aeruginosa (23%), S. aureus (19%), and A. baumannii (17%) as dominant burn-wound pathogens.Substantial resistance to β-lactams and carbapenems was observed, particularly among A. baumannii and Enterobacteriaceae.Emerging findings include a rise in carbapenemaseproducing strains and persistence of MDR organisms in environmental reservoirs.Bundled infection-control strategies, including stewardship and enhanced disinfection, achieved a 25-40% infection reduction in centres with high compliance.Recent evidence highlights the promise of probiotics, stem-cell therapeutics, and silver-based approaches as adjunctive preventive modalities.Conclusions: AMR-driven BWIs continue to challenge burn-care systems worldwide.Strengthened surveillance, consistent application of WHO/CDC prevention frameworks, and integration of bio-therapeutic and nanotechnology-based innovations are essential for sustainable infection control.