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Background    Staphylococcus epidermidis  is a common cause of nosocomial infections worldwide. This study analyzed the differences in genetic endowment and clonal lineages with pathogenesis and resistance traits of  S. epidermidis  isolates collected from community and hospital environments (patients and healthcare staff) of the same ecological niche, time period, and geographical location in China.    Methodology/Principal Findings  Molecular epidemiology and population analysis showed that nasal colonization rates of  S. epidermidis  in the community of Shanghai area of China and in healthcare personnel were 44.8% (methicillin-resistant  S. epidermidis , MRSE: 17.2%) and 61.3% (MRSE: 30.0%), respectively. 86.7% of clinical isolates were MRSE. Among the strains studied, 44 sequence types (STs) were identified with 91.7% belonging to clonal complex 2 (CC2). Only 40.8% isolates from patients were also found in healthy individuals. MRSE-ST2-SCC mec III was the predominant clone in clinical isolates, almost resistant to all antibiotics tested. Biofilm-related genes  IS256  and  icaA  were detected in majority of the predominant clinical MRSE-ST2 clone with a 40.5% biofilm-positive rate. No ST2 isolate was found in community setting. We found a high prevalence of arginine catabolic mobile element (ACME) (74.1%). The prevalence of ACME- arc  and ACME- opp3  clusters was 71.6% and 32.4%, respectively. Methicillin-sensitive  S. epidermidis  (MSSE) isolates harbored more ACME (83.3%) than MRSE isolates (67.7%), and there was no association between ACME and SCC mec  types. An association was found between low-level ACME presence and invasive infections.    Conclusions/Significance  We observed a high level of diversity within  S. epidermidis  in this study, with CC2 as the dominant clonal complex in both community and hospital settings. Only 40.8% of the isolates from patients were also found in healthy individuals. Contrary to that biofilm formation and multiple antibiotic resistance were associated closely with pathogenicity of  S. epidermidis , ACME was more likely to be an indicator for colonization rather than a virulence factor.

Molecular Analysis of Staphylococcus epidermidis Strains Isolated from Community and Hospital Environments in China