Because of rising antimicrobial resistance in the healthcare system, one of the most significant difficulties for clinicians is providing sufficient therapy for infections caused by Gram-negative bacteria. Pseudomonas aeruginosa (P. aeruginosa) is the most common Gram-negative rod infection, especially in severely sick and vulnerable individuals. Treatment options for P. aeruginosa infections have been severely limited due to antimicrobial resistance. 
P. aeruginosa has been reported to continuously sense and respond to various environmental stimuli. While establishing in the urinary tract, presence of urine, which is a complex medium, exposes invading organism to conditions like varied osmolarity, pH as well as variability of ions such as iron that act as potential virulence of P. aeruginosa and are thus critical for its pathogenicity. Extrapolation of available information may help in developing alternative preventive approach against urinary tract infections (UTIs) based on iron supplementation with far reaching consequences. 
Osmolarity is another important factor which has been reported to affect growth and virulence of
P. aeruginosa. In order to establish and cause UTI, P. aeruginosa has to adapt itself to variations in osmolarity of urine. There was significant increase in production of virulence factors with increase in osmolarity.