Genotypic and Phenotypic Insights into Biofilm-Associated Genes in Clinical Acinetobacter baumannii Isolates from Hospitalized Patients in Duhok, Iraq
Abstract
Introduction: Acinetobacter baumannii (A. baumannii) is an opportunistic pathogen responsible for various nosocomial infections, and it is also capable of forming biofilms. It commonly develops multi-drug resistance (MDR). Objectives: This study aimed to investigate the prevalence of biofilm formation in Acinetobacter baumannii isolates that were taken from various clinical specimens and to identify genetic markers associated with biofilm development. Furthermore, the study examined the relationship between the isolate’s genetic makeup and phenotypic characteristics. Methods: In this cross-sectional study, 514 consecutive clinical samples (urine, sputum, blood, CSF, wound swab, throat swab) were collected. Bacterial identification was achieved through colony morphology, Gram staining, and biochemical tests. The VITEK 2 system confirmed the isolates, and molecular confirmation was accomplished by amplifying the housekeeping gene 16srRNA. The isolates were stored at -80°C for further analysis. The phenotypic micro-titer plate test and the PCR-based identification of biofilm-forming genes identification were performed on isolated A. baumannii. Results: Among 514 clinical samples, Acinetobacter baumannii was isolated in (n = 57, 11.1%), most commonly from sputum (n = 17, 29.8%) and urine (n = 16, 28.1%). Strong biofilm formation was observed in (n = 36, 63.2%) of isolates, predominantly associated with extensively drug-resistant (XDR) profiles. Biofilm-related genes were highly prevalent: csuE (n = 55, 96.5%), bap (n = 54, 94.7%), bfmS (n = 50, 87.7%), and ompA (n = 49, 86.0%), whereas blaPER-1 was detected in a smaller fraction (n = 11, 19.3%). Resistance was widespread across β-lactams, carbapenems, aminoglycosides, and fluoroquinolones, while colistin remained the most effective antibiotic (n = 45, 78.9%). No pan-drug-resistant (PDR) isolates were identified, highlighting the persistent threat of biofilm-associated multidrug-resistant A. baumannii in clinical settings. Conclusion: Pneumonia is the primary infection caused by A. baumannii. It demonstrates significant biofilm formation accompanied by β-lactam/carbapenem drug resistance while remaining sensitive to colistin. CsuE and Bap have a strong relationship with biofilm formation.
Keywords:
Acinetobacter Baumannii, Antibiotic Resistance, Biofilms, Biofilm-Related Gene
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References
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Ahmed, M. S., Taha, Z. M., & Mosa, B. R. (2025). Phylogenetic Analysis of Acinetobacter baumannii Isolated from Veterinary Necessities. Egyptian Journal of Veterinary Sciences, 56(10), 2499-2504. https://doi.org/10.21608/ejvs.2024.291555.2108
Al-Miyah, S. A. F. (2023). Estimation the levels of two genes expression and their effects on tetracycline resistance of Acinetobacter baumannii isolated from different sources. Biodiversitas. Journal of Biological Diversity, 24(1), 176-181. https://doi.org/10.13057/biodiv/d240121
Alnakshabandie, W. M. Y., Abdullah, B. H., Khasho, D. A., & Mohammed, L. O. (2024). Multidrug Resistance Profiles of Acinetobacter Baumannii Isolated from Various Clinical Specimens in Duhok City, IRAQ. Ain Shams Medical Journal, 75(4), 967-973. https://doi.org/10.21608/asmj.2024.322955.1319
Al-Shamiri, M. M., Zhang, S., Mi, P., Liu, Y., Xun, M., Yang, E., ... & Chen, Y. (2021). Phenotypic and genotypic characteristics of Acinetobacter baumannii enrolled in the relationship among antibiotic resistance, biofilm formation and motility. Microbial Pathogenesis, 155, 104922. https://doi.org/10.1016/j.micpath.2021.104922
Appaneal, H. J., O’Neill, E., Lopes, V. V., LaPlante, K. L., & Caffrey, A. R. (2021). National trends in hospital, long-term care and outpatient Acinetobacter baumannii resistance rates. Journal of Medical Microbiology, 70(12), 001473. https://doi.org/10.1099/jmm.0.001473
Bardbari, A. M., Arabestani, M. R., Karami, M., Keramat, F., Alikhani, M. Y., & Bagheri, K. P. (2017). Correlation between ability of biofilm formation with their responsible genes and MDR patterns in clinical and environmental Acinetobacter baumannii isolates. Microbial Pathogenesis, 108, 122-128. https://doi.org/10.1016/j.micpath.2017.04.039
Bhandari, S., Upreti, M. K., Angbuhang, K. B., Shrestha, B., & Thapa Shrestha, U. (2025). Biofilm formation capacity and Carbapenem-resistance in Acinetobacter-calcoaceticus-baumannii isolated from inpatients in a tertiary care hospital in Nepal. BMC Research Notes, 18, 225. https://doi.org/10.1186/s13104-025-07211-5
Choi, C. H., Mun, S., & Oh, M. H. (2024). Identification and characterization of Acinetobacter nosocomialisBfmRS, two-component regulatory system, essential for biofilm development. Genes & Genomics, 46(5), 531-539. https://doi.org/10.1007/s13258-024-01509-7
De Oliveira, D. M. P., Forde, B. M., Kidd, T. J., Harris, P. N. A., Schembri, M. A., Beatson, S. A., ... & Walker, M. J. (2020). Antimicrobial resistance in ESKAPE pathogens. Clinical Microbiology Reviews, 33(3), https://doi.org/10.1128/CMR.00181-19
Delfan, R. R., Fekrirad, Z., Nadoushan, M. J., & Rasooli, I. (2024). Adherence and cytotoxicity of Acinetobacter baumannii on human cervical carcinoma epithelial cells: Exploring the role of anti-OmpA antibodies. Medicine in Microecology, 22, 100113. https://doi.org/10.1016/j.medmic.2024.100113
Eze, E. C., El Zowalaty, M. E., & Pillay, M. (2021). Antibiotic resistance and biofilm formation of Acinetobacter baumannii isolated from high-risk effluent water in tertiary hospitals in South Africa. Journal of Global Antimicrobial Resistance, 27, 82-90. https://doi.org/10.1016/j.jgar.2021.08.004
Gautam, D., Dolma, K. G., Khandelwal, B., Goyal, R. K., Mitsuwan, W., Pereira, M. D. L. G., ... &Nissapatorn, V. (2023). Acinetobacter baumannii insuspected bacterial infections: Association between multidrug resistance, virulence genes, & biofilm production. Indian Journal of Medical Research, 158(4), 439-446. https://doi.org/10.4103/ijmr.ijmr_3470_21
Haque, N. (2023). Antibiotic resistance, virulence and biofilm forming capacity of acinetobacter baumannii isolated from Goranchatbari sub-catchment in Dhaka city (Doctoral dissertation, Brac University). http://hdl.handle.net/10361/22150
Jabbar, R. K., Abdulsattar, B. O., & Ibrahim, S. A. (2025). Detection of OmpA and bla PER− 1 Genes and Biofilm Formation in Acinetobacter baumannii Clinical Isolates. Al-Anbar Medical Journal, 21(1). https://doi.org/10.33091/amj.2024.152827.1880
Javadi, K., Ahmadi, M. H., Rajabnia, M., &Halaji, M. (2025a). Effects of curcumin on biofilm production and associated gene in multidrug-resistant Acinetobacter baumannii isolated from hospitalized patients. International Journal of Molecular and Cellular Medicine, 14(1), 567-575. https://doi.org/10.22088/IJMCM.BUMS.14.1.567
Javadi, K., Ghaemian, P., Baziboron, M., &Pournajaf, A. (2025b). Investigating the link between biofilm formation and antibiotic resistance in clinical isolates of Acinetobacter baumannii. International Journal of Microbiology, 2025(1), 1009049. https://doi.org/10.1155/ijm/1009049
Jiang, Y., Ding, Y., Wei, Y., Jian, C., Liu, J., & Zeng, Z. (2022). Carbapenem-resistant Acinetobacter baumannii: A challenge in the intensive care unit. Frontiers in Microbiology, 13, 1045206. https://doi.org/10.3389/fmicb.2022.1045206
Joshua, A. A., Girija, A. S., Ganesh, P. S., &Priyadharsini, J. V. (2021). Distribution of Biofilm-associated Genes among Acinetobacter baumannii by in-silico PCR. Journal of Pharmaceutical Research International, 33(58A), 140-149. https://doi.org/10.9734/jpri/2021/v33i58A34099
Khoshnood, S., Sadeghifard, N., Mahdian, N., Heidary, M., Mahdian, S., Mohammadi, M., ... & Haddadi, M. H. (2023). Antimicrobial resistance and biofilm formation capacity among Acinetobacter baumannii strains isolated from patients with burns and ventilator‐associated pneumonia. Journal of clinical Laboratory Analysis, 37(1), e24814. https://doi.org/10.1002/jcla.24814
Li, S., Liu, X., Li, Z., Liu, H., & Hu, D. (2023). Combination of direct boiling and glass beads increases the purity and accuracy of bacterial DNA extraction. Biotechnology Journal, 18(11), 2300135. https://doi.org/10.1002/biot.202300135
Lucidi, M., Visaggio, D., Migliaccio, A., Capecchi, G., Visca, P., Imperi, F., & Zarrilli, R. (2024). Pathogenicity and virulence of Acinetobacter baumannii: factors contributing to the fitness in healthcare settings and the infected host. Virulence, 15(1), 2289769. DOI: 10.1080/21505594.2023.2289769
Mahmood, S. S. & Alhuda A. K., N. (2024). The prevalence of (Ompa, Csue) genes among biofilm producer acinetobacter baumannii isolates. Iraqi Journal of Agricultural Sciences, 55(5), 1720-1727. https://doi.org/10.36103/c5bw0g67
Mea, H. J., Yong, P. V. C., & Wong, E. H. (2021). An overview of Acinetobacter baumannii pathogenesis: Motility, adherence and biofilm formation. Microbiological Research, 247, 126722. https://doi.org/10.1016/j.micres.2021.126722
Mohamed, E. A., Raafat, M. M., Samir Mohamed, R., & Ali, A. E. E. (2023). Acinetobacter baumannii biofilm and its potential therapeutic targets. Future Journal of Pharmaceutical Sciences, 9(1), 82. https://doi.org/10.1186/s43094-023-00525-w
Mohammed, S. H., Ahmed, M. M., Abd Alredaa, N. A. A., Abd Alabbas, H. H., Ali, Z. D. M., Al-Wahab, Z. Z. A., ... & Zaid, N. Y. A. (2022). Prevalence of Acinetobacter Spp. isolated from clinical samples referred to Al-Kafeel Hospital and their antibiotic susceptibility patterns from 2017-2021. Iranian Journal of Medical Microbiology, 16(1), 76-82.http://dx.doi.org/10.30699/ijmm.16.1.76
Moubareck, C. A., & Halat, D. H. (2020). Insights into Acinetobacter baumannii: a review of microbiological, virulence, and resistance traits in a threatening nosocomial pathogen. Antibiotics, 9(3), 119. https://doi.org/10.3390/antibiotics9030119
Nasr, P. (2020). Genetics, epidemiology, and clinical manifestations of multidrug-resistant Acinetobacter baumannii. Journal of Hospital Infection, 104(1), 4-11. https://doi.org/10.1016/j.jhin.2019.09.021
Novović, K., &Jovčić, B. (2023). Colistin resistance in Acinetobacter baumannii: molecular mechanisms and epidemiology. Antibiotics, 12(3), 516. https://doi.org/10.3390/antibiotics12030516
Obaid, W. A. (2025). Prevalence, Antimicrobial Susceptibility, and Distribution of Biofilm Associated Virulence Genes in Multidrug-Resistant Acinetobacter baumannii Isolated from Various Environmental Sources in Baghdad Hospitals. Iraqi Journal of Science, 66(7), 2756-2775. https://doi.org/10.24996/ijs.2025.66.7.9
Olawuwo, O. S., Famuyide, I. M., & McGaw, L. J. (2022). Antibacterial and antibiofilm activity of selected medicinal plant leaf extracts against pathogens implicated in poultry diseases. Frontiers in Veterinary Science, 9, 820304. https://doi.org/10.3389/fvets.2022.820304
Palethorpe, S., Farrow III, J. M., Wells, G., Milton, M. E., Actis, L. A., Cavanagh, J., & Pesci, E. C. (2022). Acinetobacter baumannii regulates its stress responses via the BfmRS two-component regulatory system. Journal of Bacteriology, 204(2), e00494-21. https://doi.org/10.1128/jb.00494-21
Panahi, A. H., Dehvan, F., Naleini, S. N., Rouhi, S., Bechashk, S. M., Darehbagh, R. R., ... & Jafarpour, H. (2024). Prevalence of Acinetobacter baumannii with multiple drug resistance isolated from patients with ventilator-associated pneumonia from 2010 to 2020 in the world: A systematic review and meta-analysis. Reviews and Research in Medical Microbiology, 35(1), 23-35. https://doi.org/10.1097/MRM.0000000000000339
Pozo, J. L. D. (2021). Novel treatment dynamics for biofilm-related infections. Expert Review of Anti-infective Therapy, 19(11), 1443-1456. DOI: 10.1080/14787210.2021.1917993
Rajangam, S. L., & Narasimhan, M. K. (2024). Current treatment strategies for targeting virulence factors and biofilm formation in Acinetobacter baumannii. Future Microbiology, 19(10), 941-961. https://doi.org/10.2217/fmb-2023-0263
Silva, A., Costa Junior, S. D., Lima, J. L., Farias Filho, J. L. B., Cavalcanti, I. M., & Maciel, M. A. V. (2021). Investigation of the association of virulence genes and biofilm production with infection and bacterial colonization processes in multidrug-resistant Acinetobacter spp. Anais da Academia Brasileira de Ciências, 93, e20210245. https://doi.org/10.1590/0001-3765202120210245
Skerniškytė, J., Karazijaitė, E., Lučiūnaitė, A., &Sužiedėlienė, E. (2021). OmpA protein-deficient Acinetobacter baumannii outer membrane vesicles trigger reduced inflammatory response. Pathogens, 10(4), 407. https://doi.org/10.3390/pathogens10040407
Smai, S. B., &Ganjo, A. R. (2020). Prevalence of infections with antibiotic-resistant Acinetobacter baumannii in different clinical samples from hospitals in Erbil. Zanco Journal of Pure and Applied Sciences, 32(3), 95-100. https://doi.org/10.21271/ZJPAS.32.3.11
Upmanyu, K., Kumar, R., Rizwanul Haque, Q. M., & Singh, R. (2024). Exploring the evolutionary and pathogenic role of Acinetobacter baumannii biofilm-associated protein (Bap) through in silico structural modeling. Archives of Microbiology, 206(6), 267. https://doi.org/10.1007/s00203-024-03992-8
Vázquez-López, R., Solano-Gálvez, S. G., Vignon-Whaley, J. J. J., Vaamonde, J. A. A., Alonzo, L. A. P., Reséndiz, A. R., ...... & Fortes, T. B. (2020). Acinetobacter baumannii resistance: A real challenge for clinicians. Antibiotics, 9(4), 205. https://doi.org/10.3390/antibiotics9040205
Abduljabar, K. A., &Mawlood, A. H. (2023). Multilocus sequence typing analysis and molecular characterization of carbapenemase related genes in Acinetobacter baumannii isolated from hospitalized patients in Erbil city, Iraq. Cellular and Molecular Biology, 69(11), 116-124. https://doi.org/10.14715/cmb/2023.69.11.18
Ahmed, M. S., Taha, Z. M., & Mosa, B. R. (2025). Phylogenetic Analysis of Acinetobacter baumannii Isolated from Veterinary Necessities. Egyptian Journal of Veterinary Sciences, 56(10), 2499-2504. https://doi.org/10.21608/ejvs.2024.291555.2108
Al-Miyah, S. A. F. (2023). Estimation the levels of two genes expression and their effects on tetracycline resistance of Acinetobacter baumannii isolated from different sources. Biodiversitas. Journal of Biological Diversity, 24(1), 176-181. https://doi.org/10.13057/biodiv/d240121
Alnakshabandie, W. M. Y., Abdullah, B. H., Khasho, D. A., & Mohammed, L. O. (2024). Multidrug Resistance Profiles of Acinetobacter Baumannii Isolated from Various Clinical Specimens in Duhok City, IRAQ. Ain Shams Medical Journal, 75(4), 967-973. https://doi.org/10.21608/asmj.2024.322955.1319
Al-Shamiri, M. M., Zhang, S., Mi, P., Liu, Y., Xun, M., Yang, E., ... & Chen, Y. (2021). Phenotypic and genotypic characteristics of Acinetobacter baumannii enrolled in the relationship among antibiotic resistance, biofilm formation and motility. Microbial Pathogenesis, 155, 104922. https://doi.org/10.1016/j.micpath.2021.104922
Appaneal, H. J., O’Neill, E., Lopes, V. V., LaPlante, K. L., & Caffrey, A. R. (2021). National trends in hospital, long-term care and outpatient Acinetobacter baumannii resistance rates. Journal of Medical Microbiology, 70(12), 001473. https://doi.org/10.1099/jmm.0.001473
Bardbari, A. M., Arabestani, M. R., Karami, M., Keramat, F., Alikhani, M. Y., & Bagheri, K. P. (2017). Correlation between ability of biofilm formation with their responsible genes and MDR patterns in clinical and environmental Acinetobacter baumannii isolates. Microbial Pathogenesis, 108, 122-128. https://doi.org/10.1016/j.micpath.2017.04.039
Bhandari, S., Upreti, M. K., Angbuhang, K. B., Shrestha, B., & Thapa Shrestha, U. (2025). Biofilm formation capacity and Carbapenem-resistance in Acinetobacter-calcoaceticus-baumannii isolated from inpatients in a tertiary care hospital in Nepal. BMC Research Notes, 18, 225. https://doi.org/10.1186/s13104-025-07211-5
Choi, C. H., Mun, S., & Oh, M. H. (2024). Identification and characterization of Acinetobacter nosocomialisBfmRS, two-component regulatory system, essential for biofilm development. Genes & Genomics, 46(5), 531-539. https://doi.org/10.1007/s13258-024-01509-7
De Oliveira, D. M. P., Forde, B. M., Kidd, T. J., Harris, P. N. A., Schembri, M. A., Beatson, S. A., ... & Walker, M. J. (2020). Antimicrobial resistance in ESKAPE pathogens. Clinical Microbiology Reviews, 33(3), https://doi.org/10.1128/CMR.00181-19
Delfan, R. R., Fekrirad, Z., Nadoushan, M. J., & Rasooli, I. (2024). Adherence and cytotoxicity of Acinetobacter baumannii on human cervical carcinoma epithelial cells: Exploring the role of anti-OmpA antibodies. Medicine in Microecology, 22, 100113. https://doi.org/10.1016/j.medmic.2024.100113
Eze, E. C., El Zowalaty, M. E., & Pillay, M. (2021). Antibiotic resistance and biofilm formation of Acinetobacter baumannii isolated from high-risk effluent water in tertiary hospitals in South Africa. Journal of Global Antimicrobial Resistance, 27, 82-90. https://doi.org/10.1016/j.jgar.2021.08.004
Gautam, D., Dolma, K. G., Khandelwal, B., Goyal, R. K., Mitsuwan, W., Pereira, M. D. L. G., ... &Nissapatorn, V. (2023). Acinetobacter baumannii insuspected bacterial infections: Association between multidrug resistance, virulence genes, & biofilm production. Indian Journal of Medical Research, 158(4), 439-446. https://doi.org/10.4103/ijmr.ijmr_3470_21
Haque, N. (2023). Antibiotic resistance, virulence and biofilm forming capacity of acinetobacter baumannii isolated from Goranchatbari sub-catchment in Dhaka city (Doctoral dissertation, Brac University). http://hdl.handle.net/10361/22150
Jabbar, R. K., Abdulsattar, B. O., & Ibrahim, S. A. (2025). Detection of OmpA and bla PER− 1 Genes and Biofilm Formation in Acinetobacter baumannii Clinical Isolates. Al-Anbar Medical Journal, 21(1). https://doi.org/10.33091/amj.2024.152827.1880
Javadi, K., Ahmadi, M. H., Rajabnia, M., &Halaji, M. (2025a). Effects of curcumin on biofilm production and associated gene in multidrug-resistant Acinetobacter baumannii isolated from hospitalized patients. International Journal of Molecular and Cellular Medicine, 14(1), 567-575. https://doi.org/10.22088/IJMCM.BUMS.14.1.567
Javadi, K., Ghaemian, P., Baziboron, M., &Pournajaf, A. (2025b). Investigating the link between biofilm formation and antibiotic resistance in clinical isolates of Acinetobacter baumannii. International Journal of Microbiology, 2025(1), 1009049. https://doi.org/10.1155/ijm/1009049
Jiang, Y., Ding, Y., Wei, Y., Jian, C., Liu, J., & Zeng, Z. (2022). Carbapenem-resistant Acinetobacter baumannii: A challenge in the intensive care unit. Frontiers in Microbiology, 13, 1045206. https://doi.org/10.3389/fmicb.2022.1045206
Joshua, A. A., Girija, A. S., Ganesh, P. S., &Priyadharsini, J. V. (2021). Distribution of Biofilm-associated Genes among Acinetobacter baumannii by in-silico PCR. Journal of Pharmaceutical Research International, 33(58A), 140-149. https://doi.org/10.9734/jpri/2021/v33i58A34099
Khoshnood, S., Sadeghifard, N., Mahdian, N., Heidary, M., Mahdian, S., Mohammadi, M., ... & Haddadi, M. H. (2023). Antimicrobial resistance and biofilm formation capacity among Acinetobacter baumannii strains isolated from patients with burns and ventilator‐associated pneumonia. Journal of clinical Laboratory Analysis, 37(1), e24814. https://doi.org/10.1002/jcla.24814
Li, S., Liu, X., Li, Z., Liu, H., & Hu, D. (2023). Combination of direct boiling and glass beads increases the purity and accuracy of bacterial DNA extraction. Biotechnology Journal, 18(11), 2300135. https://doi.org/10.1002/biot.202300135
Lucidi, M., Visaggio, D., Migliaccio, A., Capecchi, G., Visca, P., Imperi, F., & Zarrilli, R. (2024). Pathogenicity and virulence of Acinetobacter baumannii: factors contributing to the fitness in healthcare settings and the infected host. Virulence, 15(1), 2289769. DOI: 10.1080/21505594.2023.2289769
Mahmood, S. S. & Alhuda A. K., N. (2024). The prevalence of (Ompa, Csue) genes among biofilm producer acinetobacter baumannii isolates. Iraqi Journal of Agricultural Sciences, 55(5), 1720-1727. https://doi.org/10.36103/c5bw0g67
Mea, H. J., Yong, P. V. C., & Wong, E. H. (2021). An overview of Acinetobacter baumannii pathogenesis: Motility, adherence and biofilm formation. Microbiological Research, 247, 126722. https://doi.org/10.1016/j.micres.2021.126722
Mohamed, E. A., Raafat, M. M., Samir Mohamed, R., & Ali, A. E. E. (2023). Acinetobacter baumannii biofilm and its potential therapeutic targets. Future Journal of Pharmaceutical Sciences, 9(1), 82. https://doi.org/10.1186/s43094-023-00525-w
Mohammed, S. H., Ahmed, M. M., Abd Alredaa, N. A. A., Abd Alabbas, H. H., Ali, Z. D. M., Al-Wahab, Z. Z. A., ... & Zaid, N. Y. A. (2022). Prevalence of Acinetobacter Spp. isolated from clinical samples referred to Al-Kafeel Hospital and their antibiotic susceptibility patterns from 2017-2021. Iranian Journal of Medical Microbiology, 16(1), 76-82.http://dx.doi.org/10.30699/ijmm.16.1.76
Moubareck, C. A., & Halat, D. H. (2020). Insights into Acinetobacter baumannii: a review of microbiological, virulence, and resistance traits in a threatening nosocomial pathogen. Antibiotics, 9(3), 119. https://doi.org/10.3390/antibiotics9030119
Nasr, P. (2020). Genetics, epidemiology, and clinical manifestations of multidrug-resistant Acinetobacter baumannii. Journal of Hospital Infection, 104(1), 4-11. https://doi.org/10.1016/j.jhin.2019.09.021
Novović, K., &Jovčić, B. (2023). Colistin resistance in Acinetobacter baumannii: molecular mechanisms and epidemiology. Antibiotics, 12(3), 516. https://doi.org/10.3390/antibiotics12030516
Obaid, W. A. (2025). Prevalence, Antimicrobial Susceptibility, and Distribution of Biofilm Associated Virulence Genes in Multidrug-Resistant Acinetobacter baumannii Isolated from Various Environmental Sources in Baghdad Hospitals. Iraqi Journal of Science, 66(7), 2756-2775. https://doi.org/10.24996/ijs.2025.66.7.9
Olawuwo, O. S., Famuyide, I. M., & McGaw, L. J. (2022). Antibacterial and antibiofilm activity of selected medicinal plant leaf extracts against pathogens implicated in poultry diseases. Frontiers in Veterinary Science, 9, 820304. https://doi.org/10.3389/fvets.2022.820304
Palethorpe, S., Farrow III, J. M., Wells, G., Milton, M. E., Actis, L. A., Cavanagh, J., & Pesci, E. C. (2022). Acinetobacter baumannii regulates its stress responses via the BfmRS two-component regulatory system. Journal of Bacteriology, 204(2), e00494-21. https://doi.org/10.1128/jb.00494-21
Panahi, A. H., Dehvan, F., Naleini, S. N., Rouhi, S., Bechashk, S. M., Darehbagh, R. R., ... & Jafarpour, H. (2024). Prevalence of Acinetobacter baumannii with multiple drug resistance isolated from patients with ventilator-associated pneumonia from 2010 to 2020 in the world: A systematic review and meta-analysis. Reviews and Research in Medical Microbiology, 35(1), 23-35. https://doi.org/10.1097/MRM.0000000000000339
Pozo, J. L. D. (2021). Novel treatment dynamics for biofilm-related infections. Expert Review of Anti-infective Therapy, 19(11), 1443-1456. DOI: 10.1080/14787210.2021.1917993
Rajangam, S. L., & Narasimhan, M. K. (2024). Current treatment strategies for targeting virulence factors and biofilm formation in Acinetobacter baumannii. Future Microbiology, 19(10), 941-961. https://doi.org/10.2217/fmb-2023-0263
Silva, A., Costa Junior, S. D., Lima, J. L., Farias Filho, J. L. B., Cavalcanti, I. M., & Maciel, M. A. V. (2021). Investigation of the association of virulence genes and biofilm production with infection and bacterial colonization processes in multidrug-resistant Acinetobacter spp. Anais da Academia Brasileira de Ciências, 93, e20210245. https://doi.org/10.1590/0001-3765202120210245
Skerniškytė, J., Karazijaitė, E., Lučiūnaitė, A., &Sužiedėlienė, E. (2021). OmpA protein-deficient Acinetobacter baumannii outer membrane vesicles trigger reduced inflammatory response. Pathogens, 10(4), 407. https://doi.org/10.3390/pathogens10040407
Smai, S. B., &Ganjo, A. R. (2020). Prevalence of infections with antibiotic-resistant Acinetobacter baumannii in different clinical samples from hospitals in Erbil. Zanco Journal of Pure and Applied Sciences, 32(3), 95-100. https://doi.org/10.21271/ZJPAS.32.3.11
Upmanyu, K., Kumar, R., Rizwanul Haque, Q. M., & Singh, R. (2024). Exploring the evolutionary and pathogenic role of Acinetobacter baumannii biofilm-associated protein (Bap) through in silico structural modeling. Archives of Microbiology, 206(6), 267. https://doi.org/10.1007/s00203-024-03992-8
Vázquez-López, R., Solano-Gálvez, S. G., Vignon-Whaley, J. J. J., Vaamonde, J. A. A., Alonzo, L. A. P., Reséndiz, A. R., ...... & Fortes, T. B. (2020). Acinetobacter baumannii resistance: A real challenge for clinicians. Antibiotics, 9(4), 205. https://doi.org/10.3390/antibiotics9040205
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Haji, A. and Al-Brefkani, A. (2026) “Genotypic and Phenotypic Insights into Biofilm-Associated Genes in Clinical Acinetobacter baumannii Isolates from Hospitalized Patients in Duhok, Iraq”, International Journal of Advancement in Life Sciences Research, 9(2), pp. 195-206. doi: https://doi.org/10.31632/ijalsr.2026.v09i02.015.
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