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We examined the presence of virulence and antibiotic resistance genes,  SCCmec  types and determined the genomic diversity among ocular  S. epidermidis  isolates (patients-23, healthy controls-29). PCR determined the presence of antibiotic resistance genes, virulence genes and  SCCmec  types among all isolates. MLST and PFGE determined the genomic relatedness among them. All isolates of  S. epidermidis  showed resistance to at least one class of antibiotics of which 48 isolates were multidrug resistant and carried ARGs. Thirty-five isolates were methicillin resistant and carried  mecA  gene. Majority of the isolates were resistant to fluoroquinolones and showed mutation in  gyrA, parC , and  parE  genes, however, few isolates showed additional novel mutations in  parC  gene. Of the MRSE strains, 17 strains carried SCC mec  type IV, four type V, two type II, and two UT4. Seven strains carried novel combination of  ccr  complex and SCC mercury  element, not reported earlier. All the  S. epidermidis  strains harbored  icaA  and  icaD  genes, 47 carried ACME operon, and 50 contained  IS256 . A noteworthy finding was the presence of ST179 among 43% of infected eye isolates an observation rarely reported among  S. epidermidis . PFGE and MLST analysis showed genomic diversity among them. Statistical analysis suggests that few healthy conjunctiva isolates had characteristics similar to infected eye isolates.  S. epidermidis  strains carrying  mecA  gene are multidrug resistant, virulent and diverse irrespective of sources of isolation.  IS256  cannot be used as marker to differentiate isolates of infected eye from healthy conjunctiva.

frontiers in microbiology

Identification of Major Sequence Types among Multidrug-Resistant Staphylococcus epidermidis Strains Isolated from Infected Eyes and Healthy Conjunctiva