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Peer-reviewedCC BYBurns Open

A rapid emergence of multidrug resistance pathogens in mass burn casualty patients: Longitudinal surveillance from serial blood and pus cultures

  • Salim S. Masoud
  • Raidah R. Gangji1
  • Anjela Charles2
  • Helmut Nyawale3
  • Zacharia L.Laizer2
  • Upendo Kibwana2
  • Lilian Nkinda2
  • Dominic Renatus2
  • Frank Msafri2
  • Mary Nyange4
  • Albert Ntukula4
  • Elisha Osati5
5 more authors
  • Mabula Kasubi4
  • Mtebe Majigo2
  • Agricola Joachim2
  • Joel Manyahi2
  • Doreen Kamori2
5 affiliations
  1. 1Department of Microbiology and Immunology, School of Diagnostic Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; Kairuki University, Dar es Salaam, Tanzania
  2. 2Department of Microbiology and Immunology, School of Diagnostic Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
  3. 3Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
  4. 4Department of Diagnostic and Laboratory Services, Central Laboratory Pathology, Muhimbili National Hospital, Dar es Salaam, Tanzania
  5. 5Department of Internal Medicine, Muhimbili National Hospital, Dar es Salaam, Tanzania; Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Abstract

Background: Severe burn injuries are commonly complicated by high rates of infection and antimicrobial resistance (AMR). Longitudinal data mapping microbial dynamics in burn patients, particularly following mass casualty events, are limited. The study aimed to analyzing the microbial trends and AMR patterns derived from weekly paired blood and wound specimens collected from survivors of the Morogoro disaster. Methodology: A retrospective longitudinal observation study was conducted on 13 critically ill burn patients from the 2019 disaster of a fuel tanker exploded in Morogoro, Tanzania. Weekly paired blood and deep wound swabs were collected, yielding 90 specimens over 12 weeks. Isolated bacteria were identified and tested for antibiotic susceptibility. Results: A total of 62 pathogenic isolates were recovered. A clear temporal shift was observed: initial dominance by multidrug-resistant (MDR) gram-negative pathogens ( Acinetobacter baumannii , Pseudomonas aeruginosa ) in Weeks 1–2, followed by a transition to gram-positive bacteria (Weeks 3–5), and finally a resolution phase (Weeks 6–12) characterized by sterile cultures. Resistance escalated rapidly; in A. baumannii , resistance to third-generation cephalosporins rose to 71.4% by Week 2. Concordance between blood and wound isolates confirmed the burn wound as the source of invasive infection. Mortality was 76.9%, with all fatalities attributed to sepsis. Conclusion: Serial surveillance reveals a predictable microbial succession and alarming acceleration of AMR in severely burned patients, directly linking wound colonization to lethal sepsis. These findings underscore the urgent need for protocolized serial culture-guided antibiotic stewardship and reinforced infection control in burn management.

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Cite

BibTeXRIS
BibTeX
@article{masoud2026rapid,
  title = {{A rapid emergence of multidrug resistance pathogens in mass burn casualty patients: Longitudinal surveillance from serial blood and pus cultures}},
  author = {Salim S. Masoud and Raidah R. Gangji and Anjela Charles and Helmut Nyawale and Zacharia L.Laizer and Upendo Kibwana and Lilian Nkinda and Dominic Renatus and Frank Msafri and Mary Nyange and Albert Ntukula and Elisha Osati and Mabula Kasubi and Mtebe Majigo and Agricola Joachim and Joel Manyahi and Doreen Kamori},
  journal = {Burns Open},
  year = {2026},
  month = nov,
  doi = {10.1016/j.burnso.2026.100513},
  url = {https://doi.org/10.1016/j.burnso.2026.100513},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - A rapid emergence of multidrug resistance pathogens in mass burn casualty patients: Longitudinal surveillance from serial blood and pus cultures
AU  - Salim S. Masoud
AU  - Raidah R. Gangji
AU  - Anjela Charles
AU  - Helmut Nyawale
AU  - Zacharia L.Laizer
AU  - Upendo Kibwana
AU  - Lilian Nkinda
AU  - Dominic Renatus
AU  - Frank Msafri
AU  - Mary Nyange
AU  - Albert Ntukula
AU  - Elisha Osati
AU  - Mabula Kasubi
AU  - Mtebe Majigo
AU  - Agricola Joachim
AU  - Joel Manyahi
AU  - Doreen Kamori
PY  - 2026
DA  - 2026/11/02
JO  - Burns Open
DO  - 10.1016/j.burnso.2026.100513
UR  - https://doi.org/10.1016/j.burnso.2026.100513
AB  - Background: Severe burn injuries are commonly complicated by high rates of infection and antimicrobial resistance (AMR). Longitudinal data mapping microbial dynamics in burn patients, particularly following mass casualty events, are limited. The study aimed to analyzing the microbial trends and AMR patterns derived from weekly paired blood and wound specimens collected from survivors of the Morogoro disaster. Methodology: A retrospective longitudinal observation study was conducted on 13 critically ill burn patients from the 2019 disaster of a fuel tanker exploded in Morogoro, Tanzania. Weekly paired blood and deep wound swabs were collected, yielding 90 specimens over 12 weeks. Isolated bacteria were identified and tested for antibiotic susceptibility. Results: A total of 62 pathogenic isolates were recovered. A clear temporal shift was observed: initial dominance by multidrug-resistant (MDR) gram-negative pathogens ( Acinetobacter baumannii , Pseudomonas aeruginosa ) in Weeks 1–2, followed by a transition to gram-positive bacteria (Weeks 3–5), and finally a resolution phase (Weeks 6–12) characterized by sterile cultures. Resistance escalated rapidly; in A. baumannii , resistance to third-generation cephalosporins rose to 71.4% by Week 2. Concordance between blood and wound isolates confirmed the burn wound as the source of invasive infection. Mortality was 76.9%, with all fatalities attributed to sepsis. Conclusion: Serial surveillance reveals a predictable microbial succession and alarming acceleration of AMR in severely burned patients, directly linking wound colonization to lethal sepsis. These findings underscore the urgent need for protocolized serial culture-guided antibiotic stewardship and reinforced infection control in burn management.
SN  - 2468-9122
ER  -