Prevalence of Biofilm Formation Genes in Association with Resistance Phenotypes Among <i>Pseudomonas aeruginosa</i> Clinical Isolates

Background: The emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains of Pseudomonas aeruginosa represents a significant challenge to current antibiotic therapies, particularly in immunocompromised patients, leading to severe and potentially fatal infections. Objectives: The present study aims to investigate the association between resistance patterns, the presence of the algD, pelF, and pslD genes, and biofilm formation capabilities among clinical isolates of P. aeruginosa. Methods: A total of 25 clinical strains of P. aeruginosa were isolated from clinical specimens. An antibiotic sensitivity test was conducted to categorize the organisms as resistant (R), MDR, and XDR strains. A biofilm formation assay was performed to evaluate biofilm formation capacity, and the algD, pelF, and pslD genes were detected using a polymerase chain reaction (PCR) technique. Results: All 25 clinical isolates showed the highest resistance against meropenem (MEM) (100%), imipenem (IPM) (96%), and ceftazidime (CAZ) (72%). Antimicrobial resistance (12%) and MDR (12%) strains were more prevalent in the 51 - 60 and 71 - 80 age groups, while the highest MDR (16%) strains were detected in the 81 - 90 age group. In males, R strains (28%) were isolated, and in females, the highest MDR (24%) strains were found, with no significant gender differences. In sepsis diagnosis cases, the highest antimicrobial resistance (16%), MDR (16%), and XDR (8%) strains were isolated. The algD gene was detected in R strains (36%), while pelF (40%) and pslD (40%) were detected in MDR strains. Strong biofilm formation was found in MDR (20%) and XDR (12%) strains, and moderate biofilm formation was observed in R strains (28%). Conclusions: Overall, the study found an association between biofilm formation and MDR/XDR strains. This suggests that the highest biofilm formation and percentage of pelF and pslD gene detection in MDR strains may contribute to the persistence and severity of infections caused by these strains.