title: First report on the molecular epidemiology of Malaysian Staphylococcus epidermidis isolated from a university teaching hospital.
abstract: BACKGROUND
  Staphylococcus epidermidis is a pathogen associated with nosocomial infections whose medical importance has increased due to progressively invasive medical procedures. In this study, we characterized the molecular epidemiology of S. epidermidis strains circulating in our university hospital situated in Kuala Lumpur, Malaysia.
  
  
  RESULTS
  A total of 798 S. epidermidis were isolated from our university hospital, where 56.3% of the isolates were found to be cefoxitin (methicillin) resistant and also positive for the mecA gene. Staphylococcus Cassette Chromosome mec (SCCmec) typing revealed that 39.6% of the methicillin-resistant S. epidermidis (MRSE) were SCCmec-untypeable, with 54.6% harboring the cassette chromosome recombinase C (ccrC) gene. A total of 67 isolates from the neonatal intensive care unit (NICU) was selected for pulsed-field gel electrophoresis (PFGE) typing, where 13 pulsotypes were identified at a cut-off value of 80% similarity. No significant association was found between the PFGE pulsotypes, SCCmec types and antibiotic susceptibilities. Polymerase chain reaction (PCR) assays to detect biofilm-associated genes in the ica operon and also 4 staphylococcal toxin genes (cna, seh, PVL genes and tst-1) revealed that only 8.0% isolates had the complete operon, while cna was the most prevalent toxin gene detected amongst the isolates (35.8%).
  
  
  CONCLUSIONS
  To our knowledge, this is the first report on the molecular epidemiology of Malaysian S. epidermidis. We found the strains to be low in virulence potential; nevertheless further studies have to be conducted to determine if this phenomenon translates into a better clinical outcome for patients.
authors.forename: Nurul Azirah Mohamad
authors.initials: NA
authors.lastname: Sani
authors.forename: Hassriana Fazilla
authors.initials: HF
authors.lastname: Sapri
authors.affiliation: Department of Medical Microbiology and Immunology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Molecular Biology Institute (UMBI), UKM Medical Centre, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia. hui-min@ppukm.ukm.edu.my.
authors.forename: Hui-min
authors.initials: HM
authors.lastname: Neoh
authors.forename: Salasawati
authors.initials: S
authors.lastname: Hussin
mesh_terms: D016521:Electrophoresis, Gel, Pulsed-Field; D005798:Genes, Bacterial; D006785:Hospitals, University; D008296:Malaysia; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D009876:Operon; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology; D013212:Staphylococcus epidermidis / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification