After a burn injury, the loss of the skin barrier exposes underlying tissues to microbial invasion. Initially, microbial colonization occurs when environmental or skin-resident microbes adhere to the wound surface. If local immune responses are impaired, common in severe burns, colonizing microbes may form biofilms, resist clearance, and begin to proliferate. This can lead to tissue invasion, triggering a local inflammatory response. If unchecked, this progression advances from contamination to colonization, then to infection, characterized by systemic signs like fever, leukocytosis, and delayed wound healing. Common pathogens include Pseudomonas aeruginosa, Staphylococcus aureus, and Acinetobacter baumannii.

I strongly agree with the comments from Pradeep Kumar.

Additionally, it is well documented in the associated scientific literature on epidemiology and etiology of burn wound infections that because of the loss of skin barrier, available nutrition for the microbes, and absent vascular support; burn wound is a highly vulnerable site for microbial infections where the etiologic agents can be bacteria, fungi, viruses and other organisms. These infections may be fatal if unchecked. The details of these scientific determinations and observations are in enclosed representative articles on this topic. (See attached references). I must emphasize that there is a large volume of scientific literature, including in clinical literature, which is difficult to document in the available space here.

MAITZ et al 2023 Burn wound infections microbiome and novel approaches using therapeutic microorganisms in burn wound infection control. Advanced Drug Delivery Reviews. 196: 114769 (2023).

Shahariar Shahrokhi (2023). Infections in Burns. Burn Care and Treatment, 9: 43-55 (2013).

Roy et al (2024). Microbial Infections in Burn Patients. Acute Crit Care, 39(2):214-225.