Molecular detection of toxA and lasB virulence genes of Pseudomonas aeruginosa strains isolated from Diabetic Foot Ulcers in Erbil, Iraq

Diabetic foot ulcers (DFUs) are a major cause of lower limb medical amputations and result in high healthcare expenses. In DFUs, Pseudomonas aeruginosa is significantly prevalent. The current study aims to determine the relationship between toxA and lasB virulence genes of Pseudomonas aeruginosa and antibiotic resistance. Between September 2024 and February 2025, a total of 150 swabs were collected in this cross-sectional study from DFU patients of both sexes and varying ages who attended the American Medical Complex for treatment. The primary identification was performed using cultural characteristics and biochemical tests, and the definitive identification was achieved using the Vitek 2 compact system. Antimicrobial susceptibility tests were done by the Disk diffusion method. Of 150 samples, 53 (35.33%) were identified as P. aeruginosa. Among these, the prevalence of the toxA and lasB genes was 90.56% (48/53) and 88.68% (47/53), respectively. Ceftazidime was the most effective antibiotic, followed by netilmicin, meropenem, and imipenem. Carbenicillin was the least effective (100% resistance), followed by levofloxacin, piperacillin, ciprofloxacin, and cefepime.P. aeruginosa was prevalent in DFUs, accounting for 35.33% of the total sample size. Ceftazidime is the most effective antibiotic for treating P. aeruginosa infected DFUs, followed by netilmicin, meropenem, and imipenem. Carbenicillin is less effective. The toxA and lasB virulence genes was highly prevalent in P. aeruginosa isolates, leading to increased antibiotic resistance. This study provides insights into the virulence and resistance of P. aeruginosa in diabetic foot ulcers, emphasizing the need for molecular monitoring and customized antibiotic therapies to improve clinical management.