Background:   The antibiotics active against Multidrug resistant bacteria have several limitations for their use, which include less clinical experience, During the continuing COVID-19 epidemic, limiting use has been difficult because most hospitalized COVID-19 patients receive antibiotics as a defense against subsequent bacterial infection. , Efflux pumps remove drugs and are linked to biofilm formation, making infections more difficult to treat due to a lack of therapeutic choices and necessitating new antimicrobial tactics. Pyocyanin is a secondary blue redox-active metabolite and a large family member of phenazines, tricyclic compounds. Phenazine has been utilized as a biological pesticide against several harmful microorganisms because of its antibacterial properties. Methods: Total RNA from ( Staphylococcus aureus obtained from respiratory tract  diagnosed as MDR  and Serratia marcescens obtained from co-infection Covid 19  )were isolated . The gene expression of the norA gene efflux pump of S. aureus, which was normalized to the rpoB HKG, and the smr gene efflux pump of Serratia marcescens, which was normalized to the Adnalyate Kinaze enzyme, was studied using quantitative real-time RT PCR on the extracted RNA.

Background: Multidrug Resistance forms in Gram positive and Gram negative bacteria are difficult to treat, and medications to be taken with caution may be unsuccessful. The emergence  of  treat MDR Gram-negative and Gram-positive Infections bacterial is still a major issue. Aims: The goal of this study is reliable  develop new agents or new treatment methods that are capable of overcoming drug resistance in these organisms. Methods:  536(85.3%) samples from out and inpatients who admitted to  Al  Diwaniyah Teaching Hospital in Diwaniyah city  were collected from various site of infection , 92 (46%) Pseudomonas aeruginosa  were investigated by a qualified consulting doctor. After cultivation in special media (MacConkey agar and Nutrient agar) to detect , Pseudomonas aeruginosa  , the samples were identified using the Vitec 2 compact system, Pyocyanin was extracted by standard methods from  Pseudomonas aeruginosa Principal antimicrobial compounds present in pyocyanin were identified by HPLC . Other pathogenic bacteria obtained  for exposure to Pyocyanin like Escherichia coli , K. pneumoniae ,  S. aureus from laboratories  These diagnosis was confirmed by  Vitek 2 system .  Serratia marcescens and Proteus mirabilis  obtained from sputum  patients with co- infection Covid 19.