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Background   Bacterial infection remains the most common cause of morbidity and mortality in pediatric patients with burn wounds. The increase in infection and multidrug-resistant (MDR) pathogens necessitates a periodic review of antimicrobial susceptibility patterns in the burn units. The study aimed to determine the magnitude of multidrug-resistant Gram-negative (MDRGN) bacteria in children with burn wound infections and describe the resistance patterns in the tertiary and regional hospitals in Dar es Salaam, Tanzania.Materials and Methods   The study was a hospital-based cross-sectional study design conducted between May 2017 and February 2018. Bacterial isolates from 103 wound swabs of pediatric patients with burn wounds were identified using conventional methods and API 20E. The antimicrobial susceptibility pattern was determined by the Kirby–Bauer disc diffusion method. Data were analyzed using Statistical Package for Social Science (SPSS) version 23.0.Results   A total of 136 pathogenic Gram-negative organisms were isolated from burn wound infections in pediatric patients. The most isolated Gram-negative bacterium was  Pseudomonas aeruginosa  (39.0%), followed by  Acinetobacter  spp. (28.7%) and  Klebsiella  spp. (16.2%). MDRGN strains made up 80.1% of all Gram-negative isolates. All (100%)  Klebsiella  spp. and  E. coli  were MDR, while 69.2% and 79.2% of  Acinetobacter  spp. and  P. aeruginosa , respectively, displayed MDR strains. We observed high levels of resistance to commonly prescribed antibiotics. Among  P. aeruginosa  isolates, highest resistance (81.8%) was seen toward meropenem and piperacillin, 79.5% of  Acinetobacter  spp. showed resistance to aztreonam, while 93–100% of  Klebsiella  spp and  E. coli  displayed resistance to amoxyclavulanic acid, ceftriaxone, and ceftazidime. The proportion of extended-spectrum beta-lactamase producers among  Enterobacteriaceae  was 78.6%. There was a significant higher rate of infection with MDRGN organisms in pediatric patients with a higher percentage of total burn surface area (TBSA) than patients with lower TBSA ( p  = 0.016).Conclusions    P. aeruginosa ,  Acinetobacter  spp., and  Klebsiella  spp. are the common Gram-negative pathogens causing burn wound infections in hospitalized pediatric patients in our setting. A high proportion of these organisms were multidrug resistant. The findings appeal for regular antimicrobial resistance surveillance in burn wound infection to inform empirical therapy.

High Level of Multidrug-Resistant Gram-Negative Pathogens Causing Burn Wound Infections in Hospitalized Children in Dar es Salaam, Tanzania