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Background: P. aeruginosa is considered as opportunistic bacteria that has ventilator-associated pneumonia (VAP), central line-associated bloodstream infections, ICU infections and surgical site infections. Objective: The aim is to investigate the virulence-associated proteins among P. aeruginosa that. Materials and Methods: A total of 60 Pseudomonas aeruginosa (P. aeruginosa) isolates have been recovered from seven different pecimentypes (1 CSF, 1 Pharyngeal swab, 11 ear swabs, 2 High vaginal swabs, 12 Broncoalveolar lavage, 12 wound swab, and 21 midstream urine) over the course of five months, from Sep 2019 to Jan 2020. Pseudomonas chromogenic agar was used to screen all isolates, and PCR-sequencing utilizing universal 16S rRNA gene primer was used to confirm them. Results: Patients with cystitis had a significant P aeruginosa percentage, with 21/60(35%), wound infection (12/60(20%), lower respiratory tract infection (12/60(20%), and otitis media 11/60(18.30%), whereas bacterial vaginosis had 2/60 (3.3%), meningitis and pharyngitis had 1/60(1.7%), each. The results of the bio-film formation utilizing tissue culture plate approach (TCP) indicated that 51/60(85%) have been bio-film former, whereas 9/60 (15%) have been non-biofilm former. Conclusions: The results showed that 57/60 (95%) of isolates have Ecotin, AprA, HasAp and ToxA. 58/60 (96.67%) of isolates have ExoT, EstA and PlpD. ExoS was present in 41/60(68.33%) while ExoU, ExoY, PldA and PldB were present in 34/60(56.67%), 59/60(98.33%), 53/60(88.33%) and 55/60(91.67%) of isolates respectively.

Pseudomonas aeruginosa is Gram negative bacteria that can adapt to extreme environmental conditions and withstand to different antibacterial agents. It si responsible for arrays of infections both community and hospital acquired especially ICU infections. Respiratory tract infection, blood stream infection, wound infection, burn infection, and urinary tract infections ware top five P. aeruginosa infections. Additionally as an opportunistic bacteria, it may be associated with healthcare infections in intensive care units (ICUs), ventilator-associated pneumonia (VAP), central line-associated blood stream infections, surgical site infections, otitis media, and keratitis. P. aeruginosa can form biofilms as self-produced extracellular matrix to protects the cells from antibiotics and the host immune response. Antibiotic resistance was an prominent feature of this pathogen and can donate it one of the three resistance patterns: Multidrug (MDR), extensive drug (XDR) and pan drug resistance. It exploit many resistance mechanisms ranged from overexpression of drug efflux systems protein, modifying enzyme production, reducing the permeability and using shelters like biofilms.