Role of Biofilm-Associated Virulence Genes in Chronic Wound Infections Caused by Pseudomonas aeruginosa

Abstract

Chronic wound infections caused by Pseudomonas aeruginosa are difficult to manage because biofilm formation can support bacterial persistence and reduce antimicrobial effectiveness. This study framework examined relationships between biofilm-associated virulence genes, biofilm formation, antimicrobial resistance, and clinical characteristics using a dataset of 120 patient–isolate records. Biofilm categories were derived from triplicate synthetic optical density measurements, while gene carriage and antimicrobial susceptibility classifications were generated for illustrative analysis. Overall, 107 isolates (89.2%) were classified as biofilm producers, comprising 48 weak, 42 moderate, and 17 strong producers. The genes algD, pelA, pslA, lasR, and rhlR occurred in 81.7%, 74.2%, 73.3%, 80.8%, and 72.5% of records, respectively. Gene carriage did not consistently increase with biofilm strength. Estimable unadjusted odds ratios ranged from 1.25 to 1.76, with confidence intervals encompassing unity. resistance was highest for ciprofloxacin (45.0%) and ceftazidime (44.2%), without a uniform relationship with biofilm category. These findings demonstrate an integrated analytical approach rather than clinical evidence. Gene detection alone cannot establish expression, functional activity, or causality, and planktonic susceptibility does not measure biofilm eradication. Validation using authentic specimens, molecular expression assays, direct biofilm visualization, and prospective wound outcomes is required before drawing conclusions about pathogenic mechanisms, prognostic significance, or clinical management.