# Infectious Complications in Burn Patients: A 10-Year Multicenter Study in the Petróleos Mexicanos (PEMEX) Hospital Network

## TL;DR

This study examines infection patterns and risk factors in burn patients across a Mexican hospital network over ten years, highlighting the role of Pseudomonas aeruginosa and antibiotic resistance.

## Contribution

The study provides a decade-long multicenter analysis of burn-related infections in Latin America, identifying key risk factors and resistance trends.

## Key findings

- Pseudomonas aeruginosa was the most frequent pathogen, with high resistance to tobramycin and imipenem.
- Burns >20% TBSA, ICU stay, lower extremity involvement, and advanced age were significant infection risk factors.
- The infection rate was 13.45% among 273 hospitalized burn patients.

## Abstract

Background: Infectious complications are a leading cause of morbidity and mortality in burn patients, particularly in tertiary care centers treating complex cases. The loss of the skin barrier, systemic inflammatory response, and secondary immunosuppression increase susceptibility to colonization, sepsis, and multidrug-resistant infections. Understanding the epidemiology and timing of these complications is critical to optimize prevention and treatment strategies. However, multicenter data describing long-term infection patterns and antimicrobial resistance in burn patients from Latin American healthcare networks remain limited. Additionally, evaluating a decade-long cohort allows for a more comprehensive characterization of epidemiological trends and resistance profiles over time.

Objective: This study aims to determine the prevalence of infectious complications, microbiological profile, and associated risk factors in burn patients treated in the hospital network of Petróleos Mexicanos (PEMEX).

Methods: We conducted a multicenter, retrospective, observational study based on medical record review of burn patients hospitalized in six Petróleos Mexicanos (PEMEX) health centers across Mexico between 2014 and 2024. Demographic, clinical, and microbiological data were collected. Univariate analysis with chi-squared and Mann-Whitney U tests was performed, followed by logistic regression to identify independent risk factors associated with infection. A significance level of 5% was used.

Results: We analyzed 273 hospitalized burn patients; 71.27% were men, and the mean age was 43.6 ± 18.8 years. The trunk was the most commonly affected area (52.36%), and 21.82% had burns >20% total body surface area (TBSA). The infection rate was 13.45%, with Pseudomonas aeruginosa being the most frequent pathogen (7.64%), showing high resistance to tobramycin (84.21%) and imipenem (78.4%). Factors significantly associated with infection (p < 0.05) included burns >20% TBSA, intensive care unit (ICU) stay, involvement of lower extremities, and advanced age.

Conclusions: Extensive burns, ICU admission, lower extremity involvement, and older age are significant risk factors for infectious complications. The high prevalence of Pseudomonas and its antibiotic resistance profile highlight the need for updated antimicrobial protocols and rigorous prevention strategies in burn care.