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

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