title: Prevalence of biofilm-producing Staphylococcus epidermidis in the healthy skin of individuals in Tamil Nadu, India.
abstract: OBJECTIVE
  Staphylococcus epidermidis is a major commensal bacteria. Various strains of S. epidermidis are capable of forming biofilms by attaching to several surfaces. Biofilm-forming ability of this organism is found to be associated with many hospital-acquired infections and can even impair wound healing. S. epidermidis strains producing polysaccharide-biofilms possess the intercellular adhesion (ica) operon while strains forming the protein adhesion-mediated biofilms possess the accumulation associated protein (aap) gene. We screened for biofilm-forming S. epidermidis in the skin of healthy individuals in Tamil Nadu in order to determine the risk of acquiring S. epidermidis infections in hospital settings.
  
  
  METHODS
  Skin swabs were taken from seventy two subjects residing in Chennai with healthy skin who showed no visible signs of skin lesions or allergies. S. epidermidis was isolated from 58 samples out of the 72 collected. The presence of ica operon in S. epidermidis isolates was determined by PCR and biofilm production was examined using quantitative tissue culture plate assay.
  
  
  RESULTS
  Majority of the samples (47/72; 65.3%) showed pure S. epidermidis growth, (14/72; 19.4%) showed pure Staphylococcus aureus growth and the remainder (11/72; 15.3%) showed mixed growth. Biofilm-forming S. epidermidis were found in the majority of samples (53/58; 91.4%) and ica operon was detected in 19 samples out of 58 (32.8%) which is a significantly higher percentage when compared to other studies conducted at different parts of the globe ( P = 0.0003).
  
  
  CONCLUSIONS
  We inferred that ica operon and biofilm-forming S. epidermidis are common in the healthy skin of individuals in Tamil Nadu. Measures have to be taken to reduce the risk of hospital-acquired S. epidermidis infections.
authors.affiliation: Research Core Facility GM 01/01, Faculty of Medicine, Kuwait University, Jabriya, P.O. Box 24923, Safat 13110, Kuwait.
authors.forename: C A
authors.initials: CA
authors.lastname: El Farran
authors.forename: A
authors.initials: A
authors.lastname: Sekar
authors.forename: A
authors.initials: A
authors.lastname: Balakrishnan
authors.forename: S
authors.initials: S
authors.lastname: Shanmugam
authors.forename: P
authors.initials: P
authors.lastname: Arumugam
authors.forename: J
authors.initials: J
authors.lastname: Gopalswamy
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics; D018441:Biofilms / Q000254:growth & development*; D002353:Carrier State / Q000382:microbiology*; D004269:DNA, Bacterial / Q000235:genetics; D006801:Humans; D007194:India; D009876:Operon; D016133:Polymerase Chain Reaction; D012867:Skin / Q000382:microbiology*; D013212:Staphylococcus epidermidis / Q000235:genetics / Q000302:isolation & purification* / Q000502:physiology*
chemical_list: D001426:Bacterial Proteins; D004269:DNA, Bacterial