Microbiome Profiling and Antimicrobial Efficacy of a Novel Silver-Nanoparticle Hydrogel Dressing Against Clinical Isolates From Paediatric Burn Wounds.

Burn injuries predispose paediatric patients to infection, and rising antimicrobial resistance (AMR) is reducing the effectiveness of conventional antibiotics. This underscores the need for novel antimicrobial dressings. This study characterised the microbiome and AMR profiles of paediatric burn wounds and assessed the antimicrobial efficacy of a silver nanoparticle (AgNP) hydrogel against clinical isolates. Twenty paediatric burn patients were recruited over a year, and 21 burn wounds were sampled. Three swabs were collected from each wound: one for full-length 16S rRNA sequencing, one for species identification, and one for routine microbiology. Eleven wounds (from 10 patients) were clinically infected, and 10 were uninfected. Bacterial identification used standard culture methods and MALDI-TOF. Antimicrobial susceptibility was determined using disk diffusion assays, and AgNP hydrogel efficacy was evaluated via agar-well diffusion assay. Most patients were male (65%), under 5 years of age (55%), and had sustained scald burns (60%). Maximal burn depth significantly increased the likelihood of infection (p = 0.021) and subsequent systemic antibiotic use (p = 0.02). Clinically infected wounds exhibited significantly reduced alpha diversity, while beta diversity showed no distinct clustering by infection status. Staphylococcus aureus was enriched in infected wounds, whereas S. epidermidis predominated in uninfected wounds. Culture analyses revealed high penicillin resistance among Staphylococci and cefoxitin resistance in three coagulase-negative strains. Five isolates demonstrated multidrug resistance. The AgNP hydrogel showed broad-spectrum activity against all isolates, including multidrug-resistant organisms. The AgNP hydrogel demonstrates antimicrobial activity against resistant burn wound pathogens. Large studies are required to support its clinical translation.