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Background   Pseudomonas aeruginosa  an opportunistic pathogen, is widely associated with nosocomial infections and exhibits resistance to multiple classes of antibiotics. The aim of this study was to determine the antibiotic resistance profile, biofilm formation and efflux pump activity of  Pseudomonas  strains isolated from clinical samples in Abeokuta Ogun state Nigeria.    Methods  Fifty suspected  Pseudomonas  isolates were characterized by standard biochemical tests and PCR using  Pseudomonas  species -specific primers. Antibiotic susceptibility testing was done by the disc diffusion method. Efflux pump activity screening was done by the ethidium bromide method and biofilm formation assay by the tissue plate method. Genes encoding biofilm formation ( pslA  &  plsD ) and efflux pump activity ( mexA, mexB  and  oprM ) were assayed by PCR.    Results  Thirty-nine  Pseudomonas  spp. were identified of which 35 were  Pseudomonas aeruginosa  and 4  Pseudomonas  spp. All 39 (100%)  Pseudomonas  isolates were resistant to ceftazidime, cefuroxime and amoxicillin-clavulanate. Thirty-six (92%), 10(25.6%), 20 (51.2%), 11(28%) and 9(23%) of the isolates were resistant to nitrofurantoin, imipenem, gentamicin, cefepime and aztreonam respectively. All the isolates had the ability to form biofilm and 11 (28%) of them were strong biofilm formers. They all (100%) harboured the  pslA  and  pslD  biofilm encoding genes. Varied relationships between biofilm formation and resistance to ciprofloxacin, ofloxacin, cefixime, gentamicin, imipenem, and aztreonam were observed. Only 23(59%) of the  Pseudomonas  isolates phenotypically exhibited efflux pump activity but  mexA  gene was detected in all 39 (100%) isolates while  mexB  and  oprM  genes were detected in 91%, 92%, and 88% of strong, moderate and weak biofilm formers respectively.    Conclusion  Multidrug resistance, biofilm and efflux pump capabilities in  Pseudomonas aeruginosa  have serious public health implications in the management of infections caused by this organism.

annals of clinical microbiology and antimicrobials

Evaluation of efflux pump activity and biofilm formation in multidrug resistant clinical isolates of Pseudomonas aeruginosa isolated from a Federal Medical Center in Nigeria