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However, escalating emergence of resistance poses a significant challenge. Therefore, this study aimed to investigate the prevailing patterns of aminoglycoside resistance among clinical isolates of <jats:italic>P. aeruginosa<\/jats:italic> in Iran; as well as the underlying resistance mechanisms observed in patients referred to Ardabil hospitals.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A total of 200 isolates from five hospitals were evaluated. The resistance profiles of <jats:italic>P. aeruginosa<\/jats:italic> isolates to tobramycin, amikacin, and netilmicin were determined using the disk diffusion method. The capacity of aminoglycoside-resistant isolates to form biofilms was assessed through a phenotypic assay, and the results were confirmed using the gene amplification technique. The presence of genes associated with aminoglycoside resistance was detected using polymerase chain reaction (PCR). Quantitative reverse transcription PCR (qRT-PCR) was performed to measure the expression levels of genes encoding the MexXY-OprM efflux pump and PhoPQ two-component system (TCS).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The prevalence of aminoglycoside-resistant <jats:italic>P. aeruginosa<\/jats:italic> isolates was 48%, with 94.7% demonstrating multidrug resistance (MDR). All aminoglycoside-resistant <jats:italic>P. aeruginosa<\/jats:italic> strains exhibited biofilm-forming capabilities and harbored all the genes associated with biofilm production. Among the nine genes encoding 16S rRNA methylase and aminoglycoside-modifying enzymes, three genes were detected in these isolates: <jats:italic>aac(6\u2019)-Ib<\/jats:italic> (85.4%), <jats:italic>ant(2\u2019\u2019)-Ia<\/jats:italic> (18.7%), and <jats:italic>aph(3\u2019)-VI<\/jats:italic> (3.1%). Additionally, all aminoglycoside-resistant <jats:italic>P. aeruginosa<\/jats:italic> isolates carried <jats:italic>mexY<\/jats:italic> and <jats:italic>phoP<\/jats:italic> genes, although the expression levels of <jats:italic>mexY<\/jats:italic> and <jats:italic>phoP<\/jats:italic> were 75% and 87.5%, respectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Given the considerably high prevalence of aminoglycoside-resistant <jats:italic>P. aeruginosa<\/jats:italic> strains, urgent measures are warranted to transition towards the use of novel aminoglycosides and to uphold vigilant surveillance of resistance patterns.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-024-09585-6","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T07:02:29Z","timestamp":1720508549000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Prevalence and mechanisms of aminoglycoside resistance among drug-resistant Pseudomonas aeruginosa clinical isolates in Iran"],"prefix":"10.1186","volume":"24","author":[{"given":"Nilofar","family":"Saeli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saghar","family":"Jafari-Ramedani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashid","family":"Ramazanzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Nazari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amirhossein","family":"Sahebkar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farzad","family":"Khademi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,9]]},"reference":[{"issue":"3","key":"9585_CR1","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1556\/030.2023.02060","volume":"70","author":"M Nazari","year":"2023","unstructured":"Nazari M, Ahmadi H, Hosseinzadeh S, Sahebkar A, Khademi F. 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All methods were carried out according to relevant guidelines and regulations. Clinical isolates were collected from the hospital\u2019s bacterial repository solely for research purposes, and neither patient samples nor patient data were utilized in this study. Therefore, the requirement for informed consent from participants was waived by the Regional Research Ethics Committee of Ardabil University of Medical Sciences.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"680"}}