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The burn patient is at high hazard for nosocomial infections (NI) as a result of the nature of the burn damage itself, the immune-compromising impacts of burns, prolonged clinic stays, and intensive diagnostic and therapeutic strategies. The aim of this study is to describe the actual epidemiology of burn wound colonization and infection in the Intensive Care Unit (ICU) of the Service of Burns and Plastic Surgery at the University Hospital Center in Tirana, Albania. The study is retrospective clinical and analytical. Microbiology data, total body surface area (TBSA), patient days (LOS) and mortality were collected from a hospital database for all patients admitted to the ICU of the Service of Burns at the UHC in Tirana, Albania in 2020. The burn wound infection prevalence rate was greater than in 2010 (17.2 vs. 12 infections per 100 patients), while the burn wound colonization prevalence rate was reduced by half (20.6 vs. 44 colonized patients for 100 patients). The burn wound infection incidence rate was increased (47 vs. 42.6 infections per 1000 hospitalization days) and also the attack rate was increased (0.7 vs. 0.5 infections for 100 patients in 2010). The main pathogens were grampositive bacteria (60 strains; 71%), followed by Gram-negative bacteria (22 strains; 26%), and fungi (3 strains; 3%). The predominant five bacteria were Staphylococcus aureus (55.0%), Pseudomonas aeruginosa (9%), Acinetobacter baumannii (8%), Staphylococcus coagulase-negative (8%) and Enterococcus faecalis (5%). Methicillin-resistant Staphylococcus aureus (MRSA) accounted for 55.3% (31/56) of Staphylococcal isolates. Implementation of anti-microbial stewardship programs is necessary to optimize the treatment of sepsis. [ABSTRACT FROM AUTHOR]