الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
P. aeruginosa is one of the ESKAPE pathogens capable of escaping the bacteriocidal activity of various groups. Worldwide, P. aeruginosa is known as a major nosocomial pathogen. In Egypt, MDR P. aeruginosa had emerged and present mainly in nosocomial infections due to overusage of antimicrobial agents. Therefore, a new class of antibiotics with a completely different chemical structure and mode of action is urgently needed.
This study was undertaken to investigate biofilm-forming capabilities of P. aeruginosa isolated from clinical specimens by tissue culture plate (TCP) method. Further, to investigate the antimicrobial resistance profile among and to investigate the frequency of P. aeruginosa rhlR, rhlI, lasR, lasI, lasB, toxA, aprA, algD, ExoS and plcH genes isolated from clinical samples using monoplex-PCR method and distribution of the lasB gene among biofilm-producing P. aeruginosa isolates
A total of 350 specimens were collected from patients. 125 isolates of P. aeruginosa were obtained from various clinical samples. P. aeruginosa was the most prevalent in wound exudates 35/85(41.2%), followed by ear discharge samples 32/83(38.6%), stool samples 16/45(35.6%), sputum specimens 27/87(31%) and urine samples 15/50(30%).
The antibiotic susceptibility pattern of the isolated P. aeruginosa was determined using disk diffusion method. Higest resistance was observed against Cefepime; 116 strains (92.8%), 84 strains (67.2%) to Ciprofloxacin, 75 strains (60%) to Colistin, 72 strains (57.6%) to Norfloxacin, 63 strains (50.4%) to Aztreonam, 48 strains (38.4%) to Amikacin, 36 strains (28.8%) to Gentamicin, 21 strains (16.8%) to Tobramycin, 20 strains (16%) to Piperacillin-tazobactam and 15 strains (12%) to Imipenem.
Tissue culture plate method detected 78 isolates (62.4%) as strong, 32(25.6%) as moderate and 15(12%) as weak or non-biofilm producers. The antibiotic resistance pattern of P. aeruginosa was found higher in biofilm producers than in biofilm non-producers. There has been a positive association between drug resistance and biofilm formation of P. aeruginosa.
Monoplex PCR demonstrated that 93.6% isolates were positive for one or more QS genes. lasB was the most prevalent virulence gene that was detected in P. aeruginosa isolates of this study (89.6%). Moreover, the frequencies were: aprA (85.6%), exoS (84%), algD (80%), toxA (76.8%) and plcH (75.2). Also, a significant association (P<0.05) among most of the tested virulence genes and antibiotic resistance was observed.