Background: Infection is the predominant contributor to morbidity and mortality in burn patients, and burn wound infection (BWI) is the most common reason. The objective of this research was to analyze the incidence, factors and progression of BWI, in terms of events and bacteria. Methods: Clinical variables of all qualified patients admitted to burn wards were analyzed retrospectively in 2021 at a tertiary hospital in eastern China through univariate analysis and multivariate logistic regression. The Kaplan–Meier method was also used for plotting survival curves. Isolates and resistance data were evaluated to demonstrate the evolution of targeted antibiotics of strains from BWI. Results: A total of 580 (median age, 39.5 years (23–56 years); 372/580 (64.14%) male) patients were evaluated, 348 (60.0%) of whom experienced BWI. A variety of factors are associated with BWI. Multivariate logistic regression analysis showed that depth and area of burn and duration from burn to first hospitalization are independent risk factors for BWI. For BWI onset in these patients, 47.24% (274/580) occurred in the first week. The most frequently isolated causative organism was Staphylococcus aureus (15.7%) in patients with BWI. The duration of transition from Gram-positive strains (median 3 days, (2–7 days)) to Gram-negative (median 10 days, (4–17 days)) ones isolated from burn wound shrunk. Hospital length of stay was considered as a protective factor for BWI. Conclusion: The precise assessment of factors affecting BWI in burn patients enhances prompt and suitable management. Swab cultures for surveillance could be utilized to monitor the microbiological status of burn patients.

Background: Bloodstream infection (BSI) caused by Escherichia coli has become a growing clinical threat due to its high incidence and mortality rates. Despite its significant global health burden, the genomic diversity of E. coli in Shanghai has not been systematically investigated, with ramifications for treatment and prevention. This study aimed to assess the prevalence and genomic epidemiology of E. coli BSI isolates in Shanghai, delineate predominant lineages and their related phenotypic and genomic characteristics, and elucidate the population structure. Methods: A total of 136 E. coli strains were collected from a tertiary hospital in Shanghai between 2023 and 2024. We conducted comprehensive analyses, including multilocus sequence typing (MLST), core genome MLST (cgMLST), clonal complex assignment, serotype prediction, identification of antimicrobial resistance genes (ARGs) and plasmid-borne virulence genes, and plasmid mobility prediction. Results: The predominant clonal complex was CC131 (22.8%), followed by CC14 (14%). The highest resistance rate was observed for ampicillin (85.3%), whereas amikacin (3.7%), ertapenem (2.9%), imipenem (2.9%), minocycline (2.2%), and meropenem (2.2%) retained excellent in vitro activity. High resistance to ciprofloxacin (63.2%) and levofloxacin (62.5%) was observed, primarily mediated by mutations in gyrA (S83L, D87N) and parC (S80I), particularly in ST1193 strains. Plasmid-borne siderophore virulence genes co-occurred as gene modules, the majority of which were located on transferable IncFIB plasmids. However, this trend was not uniform across lineages, with the CC131 clones predominantly carrying mobilizable plasmids, while CC14 clones predominantly harbored non-mobilizable plasmids. Conclusions: Our findings reveal the dynamic genetic diversity of E. coli BSI isolates at a tertiary hospital in Shanghai, highlighting the importance of genomic surveillance and providing valuable insights for infection control.