Abstract
Goal Dynamic analysis of the transformation of the microbial landscape of burn wounds at different stages of hospitalization as an objective assessment of predictors of their prolonged healing. Materials and methods This was a prospective, observational, single-center longitudinal study with repeated measures. Bacteriological examination was conducted on 112 samples obtained from the surface of burn wounds in 38 hospitalized patients, collected at specific time points after injury. The microbial landscape of the wounds was analyzed, including species identification of pathogens, assessment of their antibiotic susceptibility, the degree of wound contamination and the presence of microbial associations. Pathogen identification was performed using the Vitek 2 Compact 30 analyzer. Total microbial contamination was assessed using the plate count method. Results Resistant bacteria were isolated from the surface of burn wounds from the third day of hospitalization. During treatment, a change in pathogens was observed, associated with the length of the hospital stay. As the duration of hospitalization increased, there was a corresponding rise in the degree of microbial contamination of the wounds, as well as in the frequency of Gram-negative bacteria from the ESKAPE group, multidrug-resistant microorganisms and microbial associations. Conclusion The study found that resistant bacteria emerged in burn wounds as early as the third day. More than 30 % of clinical isolates exhibited resistance to six or more antibiotics at the primary inoculation stage (3–5 days), increasing to 80 % by days 21–24. These findings underscore the critical role of infection in delayed wound healing, highlighting the importance of early surgical treatment. The developed clinical and laboratory assessment algorithm is recommended as a predictive tool for identifying complicated wound progression and prolonged healing in burn patients.