@article{eprints18253,
          author = {P. A. Akinduti and Onome W. George and Hannah U. Ohore and Olusegun E. Ariyo and Samuel T. Popoola and Adenike I. Adeleye and Kazeem S. Akinwande and JACOB OLAGBENRO POPOOLA and S. O Rotimi and Fredrick O. Olufemi and Conrad A. Omonhinmin and G. I Olasehinde},
            year = {2023},
           month = {March},
          number = {3},
           pages = {626},
         journal = {Antibiotics},
           title = {Evaluation of Efflux?Mediated Resistance and Biofilm formation in
Virulent Pseudomonas aeruginosa Associated with Healthcare Infections},
       publisher = {MDPI},
          volume = {12},
             url = {http://eprints.covenantuniversity.edu.ng/18253/},
        abstract = {Pseudomonas aeruginosa is a significant pathogen identified with healthcare-associated infections. The present study
evaluates the role of biofilm and efflux pump activities in influencing high-level resistance in virulent P.
aeruginosa strains in clinical infection. Phenotypic resistance in biotyped Pseudomonas aeruginosa (n = 147) from
diagnosed disease conditions was classified based on multiple antibiotic resistance (MAR) indices and analysed with
logistic regression for risk factors. Efflux pump activity, biofilm formation, and virulence factors were analysed for optimal
association in Pseudomonas infection using receiver operation characteristics (ROC). Age-specificity (OR [CI] = 0.986
[0.946?1.027]), gender (OR [CI] = 1.44 [0.211?9.827]) and infection sources (OR [CI] = 0.860 [0.438?1.688]) were risk
variables for multidrug resistance (MDR)-P. aeruginosa infection (p {\ensuremath{<}} 0.05). Biofilm formers caused 48.2\% and 18.5\%
otorrhea and wound infections (95\% CI = 0.820?1.032; p = 0.001) respectively and more than 30\% multidrug resistance
(MDR) strains demonstrated high-level efflux pump activity (95\% CI = 0.762?1.016; p = 0.001), protease (95\% CI =
0.112?0.480; p = 0.003), lipase (95\% CI = 0.143?0.523; p = 0.001), and hemolysin (95\% CI = 1.109?1.780; p = 0.001).
Resistance relatedness of more than 80\% and 60\% to cell wall biosynthesis inhibitors (ceftazidime, ceffproxil,
augumentin, ampicillin) and, DNA translational and transcriptional inhibitors (gentamicin, ciprofloxacin, ofloxacin,
nitrofurantoin) were observed (p {\ensuremath{<}} 0.05). Strong efflux correlation (r = 0.85, p = 0.034) with MDR strains, with high
predictive performances in efflux pump activity (ROC-AUC 0.78), biofilm formation (ROC-AUC 0.520), and virulence
hierarchical-clustering. Combine activities of the expressed efflux pump and biofilm formation in MDR-P.
aeruginosa pose risk to clinical management and infection control.},
        keywords = {Pseudomonas aeruginosa; antibiotic resistance; biofilm; efflux pump; virulence factors}
}