Antibacterial resistance of Healthcare-Associated Infection (HAI) agents is a major public health problem world wide. Pseudomonas aeruginosa is one of the main HAI agents especially in intensive care units (ICUs). The present study focuses on the identification of antibacterial resistance genetic determinants and on determining the structure of mobile genetic elements — novel class 1 integrons of P. aeruginosa. P. aeruginosa strains (n=105) were collected in the department of Moscow neurosurgery ICU in 2013—2016 from respiratory system (60.0%), urine (28.6%), surgical wounds (5.7%), blood (2.9%), and cerebrospinal fluid (2.9%). Major (92.4%) strains characterized by the phenotype of multi drug resistance. Beta-lactamase genes blaVIM-2-like which are widely distributed in Russia were identified in 37.7% strains. The blaCTX-M-15 gene was carried by 3.0% strains that is the first report of such gene identification in P. aeruginosa in Russia. Class 1 integrons were detected in 63.0% strains, of which 36.7% strains carried 7 types of gene cassette arrays: (blaVIM-2-like), (aadA6-gcuD), (aacA7-blaVIM-2-like), (aac(3’)Ic-cmlA5), (aadA6Δ3::ISPa21e-gcuD), (gcu87-aadB-aphA15d-aadA1a), and (blaPBL-1-aacA4). The last three gene cassette arrays are new for class 1 integrons. The identification numbers have been assigned to novel integrons:In1379, In1360, and In1375. New genetic structures were described: the aadA6 gene cassette with inserted ISPa21ye element (In1379); the gsu87 gene cassette coding hypothetical protein which is not represented in GenBank database (In1360); novel allele of aphA15d gene cassette and the blaPBL-1 gene cassette coding new, not previously described, beta-lactamase of class A (In1375). Identification of novel genetic structures of antibacterial resistance in P. aeruginosa strains isolated during three years indicates activity of genetic processes, associated with antibiotic resistance in hospital pathogens in the department of neuroreanimation indicates the activity of genetic processes associated with the formation of multiple drug resistance of hospital pathogens.