{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T04:15:06Z","timestamp":1780546506145,"version":"3.54.1"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n \n \n Pseudomonas aeruginosa<\/jats:italic>\n <\/jats:italic>\n remains a major cause of hospital- and community-acquired infections, with increasing ciprofloxacin resistance driven by mutations in quinolone resistance\u2013determining regions (QRDRs) and plasmid-mediated mechanisms. This study aimed to determine the prevalence of key virulence genes\n \n (oprI, toxA, lasB, nan1)<\/jats:italic>\n <\/jats:italic>\n and ciprofloxacin resistance determinants\n \n (gyrA, parC, qnrA, qnrB, qnrS<\/jats:italic>\n <\/jats:italic>\n ) in clinical isolates from Khartoum State, Sudan, and to explore associations with demographic and clinical variables.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This cross-sectional study, which was conducted from January to April 2023, included eighty-six clinical isolates of\n \n P.aeruginosa<\/jats:italic>\n <\/jats:italic>\n that were collected from various hospitals in Khartoum State. The isolates were reidentified via standard microbiological techniques, and DNA was extracted via the boiling method. Multiplex polymerase chain reaction was utilized to detect the presence of virulence and ciprofloxacin resistance genes. Data analysis was performed via IBM SPSS software (version 20).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n All the isolates carried one or more virulence genes, with oprI being the most prevalent (88.4%), followed by\n \n lasB<\/jats:italic>\n <\/jats:italic>\n (80.2%),\n \n toxA<\/jats:italic>\n <\/jats:italic>\n (57%), and nan1 (6.98%). Among the isolates, 30 (34.9%) were resistant to ciprofloxacin, whereas 56 (65.1%) were susceptible. All resistant isolates carried at least one of the resistance genes studied. The\n \n parC<\/jats:italic>\n <\/jats:italic>\n gene was the most prevalent (40.7%), followed by\n \n gyrA<\/jats:italic>\n <\/jats:italic>\n (20.9%) and\n \n qnrS<\/jats:italic>\n <\/jats:italic>\n (19.8%).\n \n qnrA<\/jats:italic>\n <\/jats:italic>\n and\n \n qnrB<\/jats:italic>\n <\/jats:italic>\n each had a prevalence of 17.4%. This investigation revealed the coexistence of the\n \n gyrA<\/jats:italic>\n <\/jats:italic>\n and\n \n parC<\/jats:italic>\n <\/jats:italic>\n genes in seven isolates (23.3%), and we also reported that the\n \n qnrA<\/jats:italic>\n <\/jats:italic>\n ,\n \n qnrB,<\/jats:italic>\n <\/jats:italic>\n and\n \n qnrS<\/jats:italic>\n <\/jats:italic>\n genes coexisted in 11 (36.7%) of the ciprofloxacin resistant\n \n P. aeruginosa<\/jats:italic>\n <\/jats:italic>\n isolates. A significant association was detected between ciprofloxacin resistance and the presence of the\n \n gyrA<\/jats:italic>\n <\/jats:italic>\n ,\n \n qnrS<\/jats:italic>\n <\/jats:italic>\n ,\n \n qnrA<\/jats:italic>\n <\/jats:italic>\n , and\n \n qnrB<\/jats:italic>\n <\/jats:italic>\n genes (p\u2009<\u20090.001) but not the\n \n parC<\/jats:italic>\n <\/jats:italic>\n gene (p\u2009=\u20090.6). There was no significant association between ciprofloxacin resistance genes and virulence genes (p\u2009>\u20090.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The prudent use of ciprofloxacin is vital in managing\n \n P.aeruginosa<\/jats:italic>\n <\/jats:italic>\n infections amid rising resistance. Detection of\n \n gyrA<\/jats:italic>\n <\/jats:italic>\n and\n \n parC<\/jats:italic>\n <\/jats:italic>\n in susceptible isolates signals potential for future resistance through future mutations, highlighting the need for ongoing monitoring. The coexistence of resistance and virulence genes highlights the pathogen\u2019s combined threat. These findings reinforce the public health importance of continuous molecular surveillance and genetic profiling, not only to guide effective treatment but also to inform targeted infection control strategies and antimicrobial stewardship programs.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0335269","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T17:59:47Z","timestamp":1761933587000},"page":"e0335269","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Molecular genetic portrait of virulence and ciprofloxacin resistance genes in clinical Pseudomonas aeruginosa Isolates from Khartoum, Sudan"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8345-5666","authenticated-orcid":true,"given":"Azza Salah Imam","family":"Abdallah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maye M.","family":"Merghani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musa","family":"Abdalla Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"issue":"1","key":"pone.0335269.ref001","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.biotechadv.2018.11.013","article-title":"Antibiotic resistance in Pseudomonas aeruginosa: mechanisms and alternative therapeutic strategies","volume":"37","author":"Z Pang","year":"2019","journal-title":"Biotechnol Adv"},{"key":"pone.0335269.ref002","doi-asserted-by":"crossref","first-page":"104574","DOI":"10.1016\/j.meegid.2020.104574","article-title":"Acquired fluoroquinolone resistance genes in corneal isolates of Pseudomonas aeruginosa","volume":"85","author":"M Khan","year":"2020","journal-title":"Infect Genet Evol"},{"issue":"2","key":"pone.0335269.ref003","doi-asserted-by":"crossref","first-page":"178","DOI":"10.3390\/antibiotics14020178","article-title":"Difficult-to-Treat Pseudomonas aeruginosa Infections in Critically Ill Patients: A Comprehensive Review and Treatment Proposal","volume":"14","author":"P Vidal-Cort\u00e9s","year":"2025","journal-title":"Antibiotics (Basel)"},{"issue":"1","key":"pone.0335269.ref004","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1186\/s12879-019-4522-1","article-title":"Chromosomal and plasmid-mediated fluoroquinolone resistance in human Salmonella enterica infection in Ghana","volume":"19","author":"G Acheampong","year":"2019","journal-title":"BMC Infect Dis"},{"key":"pone.0335269.ref005","doi-asserted-by":"crossref","unstructured":"Chand Y, Khanal S, Panta OP, Shrestha D, Khadka DK, Poudel P. 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