Molecular characterization of resistance and biofilm genes of ESKAPE pathogens isolated from clinical samples: examination of the effect of boric acid on biofilm ability by cell culture method.

Biofilm formation ranks first among the resistance and virulence factors crucial in forming ESKAPE pathogens. Once biofilm is formed, treating the infection with existing drugs is often futile. Therefore, in this study, resistant ESKAPE pathogens were isolated from intensive care units and sent to Atatürk University Yakutiye Research Hospital Microbiology Laboratory. This study investigated the biofilm formation and molecular characterization of resistant ESKAPE pathogens isolated from intensive care units. The bacteria's biofilm formation abilities, genes responsible for biofilm formation, and resistance characteristics were identified. The effect of boric acid (BA) on resistance and bacterial genes was evaluated by a bacterial infection cell culture model. The highest biofilm formation was observed in Escherichia coli, Enterococcus spp., and Pseudomonas aeruginosa Enterococcus spp. isolates showed the vanA gene in 14.6% and the vanC gene in 61% of the samples. Among Staphylococcus spp. isolates, 48.3% were MSSA, 34.5% were MRCNS, and 17.2% were MRSA. The KPC gene was detected in 50%, the OXA-48 gene in 40%, and the NDM gene in 15% of the isolates. In P. aeruginosa, the LasI and LasR quorum sensing system genes were found in 38.5% and 30.8% of the isolates, respectively. In E. coli isolates, OXA-48 was present in 35%, KPC in 31.7%, and TEM in 12.5%. BA demonstrated significant activity against ESKAPE pathogens. The combined antimicrobial activity of boron compounds showed a decrease in the expression level of the resistance gene. It will be promising for preventing hospital-associated infections.