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However, little information exists regarding the characterization of\n                      <jats:italic>S. aureus<\/jats:italic>\n                      in BSI patients in Shandong, China. To identify the clonality, virulence genes, and antibiotic resistance of\n                      <jats:italic>S. aureus<\/jats:italic>\n                      in blood, a total of 101 nonrepetitive blood isolates were collected. The antibiotic resistance phenotypes were determined, and virulence genes were analyzed with polymerase chain reaction (PCR). Finally, the genetic relatedness was investigated with Staphylococcus chromosomal cassette\n                      <jats:italic>mec<\/jats:italic>\n                      (SCC\n                      <jats:italic>mec<\/jats:italic>\n                      ) typing for methicillin-resistant\n                      <jats:italic>S. aureus<\/jats:italic>\n                      (MRSA) isolates, Staphylococcal protein A (\n                      <jats:italic>spa<\/jats:italic>\n                      ), and multilocus sequence typing (MLST) for all of 101 isolates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 101\u2009\n                      <jats:italic>S. aureus<\/jats:italic>\n                      isolates, 24 MRSA isolates and 77 methicillin-susceptible\n                      <jats:italic>S. aureus<\/jats:italic>\n                      (MSSA) isolates were identified. Overall, MRSA isolates had higher resistance rates than MSSA isolates when exposed to any of the 15 antibiotics tested in this study except for trimethoprim\/sulfamethoxazole. Among the 17 virulence genes tested in this study,\n                      <jats:italic>hla<\/jats:italic>\n                      ,\n                      <jats:italic>hld<\/jats:italic>\n                      , and\n                      <jats:italic>hlg<\/jats:italic>\n                      could be detected in all isolates. MRSA isolates were more likely to carry\n                      <jats:italic>seb<\/jats:italic>\n                      and\n                      <jats:italic>hlb<\/jats:italic>\n                      genes, while MSSA isolates were more likely to carry\n                      <jats:italic>seg<\/jats:italic>\n                      and\n                      <jats:italic>sei<\/jats:italic>\n                      genes. Thirty-five sequence types (STs) and 49\n                      <jats:italic>spa<\/jats:italic>\n                      types were identified, of which ST59-t437 and ST398-t571 were the most abundant. These two genotypes were also the most abundant ST-\n                      <jats:italic>spa<\/jats:italic>\n                      types in MRSA and MSSA isolates, but their abundances shifted over time, with ST398-t571 being the predominant genotype from 2016 to 2017, and ST59-t437 from 2018 to 2020. Besides, all the ST59-t437 isolates harbored\n                      <jats:italic>hlgb<\/jats:italic>\n                      gene, whereas most (88.9%) ST398-t571 did not. In addition, twenty-four MRSA isolates were subject to SCC\n                      <jats:italic>mec<\/jats:italic>\n                      typing. SCC\n                      <jats:italic>mec<\/jats:italic>\n                      IVa was the most prevalent SCC\n                      <jats:italic>mec<\/jats:italic>\n                      type, and all the ST59-t437 MRSA isolates were SCC\n                      <jats:italic>mec<\/jats:italic>\n                      IVa. We also observed 15 new STs, and some of them were MRSA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      These findings provide additional observations and epidemiological data for blood\n                      <jats:italic>S. aureus<\/jats:italic>\n                      isolates, which can improve future infection-control measures and aid in potential clinical treatments in hospitals and other clinical settings.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12866-021-02344-6","type":"journal-article","created":{"date-parts":[[2021,10,17]],"date-time":"2021-10-17T23:53:00Z","timestamp":1634514780000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Clonality, virulence genes, and antibiotic resistance of Staphylococcus aureus isolated from blood in Shandong, China"],"prefix":"10.1186","volume":"21","author":[{"given":"Xuezhi","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongzi","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zengqi","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinmei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenyan","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pen","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaiqi","family":"Jing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiazheng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,10,18]]},"reference":[{"issue":"11","key":"2344_CR1","doi-asserted-by":"publisher","first-page":"1373","DOI":"10.1080\/14760584.2016.1179583","volume":"15","author":"GH Dayan","year":"2016","unstructured":"Dayan GH, Mohamed N, Scully IL, Cooper D, Begier E, Eiden J, et al. 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As this study just focuses on bacteria alone and does not use any human material or patient information, the Review Board of the Ethics Committee of The First Affiliated Hospital of Shandong First Medical University exempted this study from review and waived the need for informed consent. All methods were carried out in accordance with relevant guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"281"}}