Resistant microorganisms such as Pseudomonas aeruginosa grow by developing biofilms in hospitals. We aimed to investigate the biofilm formation and the frequencies of biofilm-related genes and their associations with antibiotic resistance pattern in P. aeruginosa isolated from Iranians’ clinical samples. This review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted a systematic literature search in scientific databases using medical subject heading terms, including “Pseudomonas aeruginosa,” “biofilm formation,” “biofilm-related genes,” “antibiotic resistance,” and “prevalence,” to obtain related articles published from 1st January, 2000, to 30th March, 2019. The studies reporting the prevalence of biofilm formation, the frequencies of biofilm-related genes, and the antibiotic resistance pattern in P. aeruginosa retrieved from Iranian patients were included. Meta-analysis was performed using the Comprehensive Meta-Analysis software. The pooled rate of biofilm formation was calculated as 86.5% (95% confidence interval [CI]: 79–91.6). The combined frequencies of strong, moderate, and weak biofilms were 51% (95% CI: 37.4–64.4), 29.2% (95% CI: 20.9–39.1), and 25.4% (95% CI: 11.5–47.2), respectively. The pooled prevalence of laslR, algD, algU, ppyR, and pelF genes were 93.6% (95% CI: 88.1–96.6), 91.4% (95% CI: 80.8–96.4), 89.3% (95% CI: 85.2–92.3), 98.7% (95% CI: 96.5–99.6), and 93% (95% CI: 82.7–97.3), respectively. The highest combined antibiotic resistance rates of P. aeruginosa isolates were against piperacillin/tazobactam (90%). This study showed that biofilm formation was higher in multidrug-resistant (MDR) P. aeruginosa than non-MDRs. A significant correlation was observed between biofilm formation and antibiotic resistance in 50% of studies included in this review.

中文翻译：

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从临床样本中分离出的铜绿假单胞菌中生物膜形成、抗生素耐药模式和生物膜相关基因的荟萃分析。

铜绿假单胞菌等耐药微生物通过在医院中形成生物膜而生长。我们旨在调查从伊朗人的临床样本中分离出的铜绿假单胞菌的生物膜形成和生物膜相关基因的频率及其与抗生素耐药模式的关联。该评价是根据系统评价和元分析的首选报告项目 (PRISMA) 指南进行的。我们使用医学主题词在科学数据库中进行了系统的文献检索，包括“铜绿假单胞菌”，“生物膜形成”、“生物膜相关基因”、“抗生素耐药性”和“流行率”，以获取 2000 年 1 月 1 日至 2019 年 3 月 30 日发表的相关文章。生物膜相关基因的数量，以及从伊朗患者中提取的铜绿假单胞菌的抗生素耐药模式。使用综合 Meta 分析软件进行 Meta 分析。生物膜形成的合并率计算为 86.5%（95% 置信区间 [CI]：79-91.6）。强、中、弱生物膜的组合频率分别为 51% (95% CI: 37.4–64.4)、29.2% (95% CI: 20.9–39.1) 和 25.4% (95% CI: 11.5–47.2) . 的汇总流行laslR，ALGD，algU、ppyR和pelF基因分别为 93.6% (95% CI: 88.1–96.6)、91.4% (95% CI: 80.8–96.4)、89.3% (95% CI: 85.2–92.3)、98.7% (95% CI) : 96.5–99.6) 和 93% (95% CI: 82.7–97.3)。铜绿假单胞菌分离株的最高联合抗生素耐药率是针对哌拉西林/他唑巴坦 (90%)。该研究表明，多重耐药 (MDR)铜绿假单胞菌的生物膜形成率高于非 MDR。本综述中 50% 的研究观察到生物膜形成与抗生素耐药性之间存在显着相关性。