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<p>Nowadays,<i> Pseudomonas aeruginosa</i> is recognized as an important and common opportunistic pathogen in nosocomial infections, particularly in patients with wounds and burns. Its ability to form biofilms, express virulence-associated genes, and resist multiple antibiotics presents significant therapeutic challenges. The aim of this study was to investigate the prevalence and characteristics of multidrug-resistant (MDR) <i>P. aeruginosa</i> strains, focusing on biofilm formation, serotype distribution, and virulence gene expression in isolates obtained from wound and burn infections. In this study, a total of 150 clinical isolates of <i>P. aeruginosa</i> were collected from hospitalized patients at Baghdad Medical City between 2022 and 2024. Bacterial identification was performed using standard phenotypic and biochemical methods (API 20E). Antibiotic susceptibility testing was performed using the disk diffusion method according to EUCAST guidelines. Isolates resistant to three or more classes of antibiotics were defined as MDR isolates. Extended-spectrum β-lactamase (ESBL) production was detected using the double-disk synergy test. Biofilm formation was evaluated via microtiter plate assay. The prevalence of serotypes, quorum sensing systems, and virulence genes was investigated using the multiplex PCR technique. Analysis of <i>P. aeruginosa</i> isolates from wound and burn patients demonstrated that 59% of the strains exhibited MDR, accompanied by robust biofilm formation capacity and a high prevalence of virulence genes such as <i>las</i>B and <i>apr</i>A. Quorum sensing regulatory genes, notably <i>rhl</i>R and <i>las</i>R, were also highly prevalent. The highest antibiotic resistance rates were observed against gentamicin and erythromycin, whereas all isolates remained susceptible to colistin. Serotypes O11 and O4 were the most frequently identified. Moreover, ESBL producing strains showed significantly higher antibiotic resistance levels compared to non-ESBL producers, underscoring their clinical significance. The observed prevalence of MDR <i>P. aeruginosa</i> in this study was markedly higher than many previous reports from regional and global contexts, highlighting the local epidemiological landscape. The concurrence of high MDR prevalence, strong biofilm production, and virulence gene expression presents a substantial challenge to effective nosocomial infection management. These findings emphasize the urgent need to reinforce infection control strategies, promote rational antibiotic stewardship, and implement targeted therapeutic interventions based on the genetic profiles of the isolates to curb resistance dissemination and improve clinical outcomes.</p>

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Multidrug-resistant Pseudomonas aeruginosa in wound and burn infections: resistance, virulence, serotypes and biofilm characteristics in Baghdad

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月7日

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  • Zainab Alnaji,
  • Eman Jassim Mohammed,
  • Mohammed Allami,
  • Salsabil A. jassim

摘要

Nowadays, Pseudomonas aeruginosa is recognized as an important and common opportunistic pathogen in nosocomial infections, particularly in patients with wounds and burns. Its ability to form biofilms, express virulence-associated genes, and resist multiple antibiotics presents significant therapeutic challenges. The aim of this study was to investigate the prevalence and characteristics of multidrug-resistant (MDR) P. aeruginosa strains, focusing on biofilm formation, serotype distribution, and virulence gene expression in isolates obtained from wound and burn infections. In this study, a total of 150 clinical isolates of P. aeruginosa were collected from hospitalized patients at Baghdad Medical City between 2022 and 2024. Bacterial identification was performed using standard phenotypic and biochemical methods (API 20E). Antibiotic susceptibility testing was performed using the disk diffusion method according to EUCAST guidelines. Isolates resistant to three or more classes of antibiotics were defined as MDR isolates. Extended-spectrum β-lactamase (ESBL) production was detected using the double-disk synergy test. Biofilm formation was evaluated via microtiter plate assay. The prevalence of serotypes, quorum sensing systems, and virulence genes was investigated using the multiplex PCR technique. Analysis of P. aeruginosa isolates from wound and burn patients demonstrated that 59% of the strains exhibited MDR, accompanied by robust biofilm formation capacity and a high prevalence of virulence genes such as lasB and aprA. Quorum sensing regulatory genes, notably rhlR and lasR, were also highly prevalent. The highest antibiotic resistance rates were observed against gentamicin and erythromycin, whereas all isolates remained susceptible to colistin. Serotypes O11 and O4 were the most frequently identified. Moreover, ESBL producing strains showed significantly higher antibiotic resistance levels compared to non-ESBL producers, underscoring their clinical significance. The observed prevalence of MDR P. aeruginosa in this study was markedly higher than many previous reports from regional and global contexts, highlighting the local epidemiological landscape. The concurrence of high MDR prevalence, strong biofilm production, and virulence gene expression presents a substantial challenge to effective nosocomial infection management. These findings emphasize the urgent need to reinforce infection control strategies, promote rational antibiotic stewardship, and implement targeted therapeutic interventions based on the genetic profiles of the isolates to curb resistance dissemination and improve clinical outcomes.