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Therefore, four typical <jats:italic>Staphylococcus aureus<\/jats:italic> (<jats:italic>S. aureus)<\/jats:italic> strains from different clinical specimens were derivated by vancomycin in vitro to better clarify their phenotypic and molecular characteristics. Some experiments, such as stepwise selection of vancomycin-resistant strains, pulsed-field gel electrophoresis (PFGE), antimicrobial susceptibility test, population analysis profile-area under the curve (PAP-AUC), molecular typing, transmission electron microscopy, \u03b4-hemolysin expression, autolysis assay, biofilm assay and quantitative real-time polymerase chain reaction (qPCR) for gene expression were carried out to compare the derivated bacteria with their parental strains. Results showed that the observed phenotypes of vancomycin-resistant strains such as hemolysin, autolysis and biofilm significantly reduced, which were associated with vancomycin resistance capability of the selected strain. The changes of phenotype and regulatory genes expression were inversely proportional to the vancomycin minimum inhibitory concentration (MICvan). Most heterogeneous vancomycin intermediate <jats:italic>Staphylococcus aureus<\/jats:italic> (hVISA) or VISA strains belonged to <jats:italic>spa<\/jats:italic> type t570 and <jats:italic>agr<\/jats:italic> group II. In summary, the clinical isolated vancomycin susceptible <jats:italic>Staphylococcus aureus<\/jats:italic> (VSSA), hVISA and VISA could be derivated into high vancomycin-resistant VISA in vitro, but it was difficult for them to develop into vancomycin resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (VRSA). VISA and hVISA could gradually adapt to the environment with the vancomycin concentration that continuously elevates.<\/jats:p>","DOI":"10.1515\/med-2018-0071","type":"journal-article","created":{"date-parts":[[2018,10,26]],"date-time":"2018-10-26T09:02:01Z","timestamp":1540544521000},"page":"475-486","source":"Crossref","is-referenced-by-count":9,"title":["Phenotypic and molecular characterisation of Staphylococcus aureus with reduced vancomycin susceptibility derivated in vitro"],"prefix":"10.1515","volume":"13","author":[{"given":"Jia","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology and Parasitology , College of Basic Medical Sciences , China Medical University , Shenyang , PR China"},{"name":"Department of Medical Microbiology , Key Laboratory of Environmental Pollution and Microecology of Liaoning Province, Shenyang Medical College , Shenyang , PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology , College of Basic Medical Sciences , China Medical University , Shenyang , PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao Xue","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology , College of Basic Medical Sciences , China Medical University , No.77 Puhe Road, Shenyang North New Area, Shenyang , Liaoning Province , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology , College of Basic Medical Sciences , China Medical University , Shenyang , PR China"},{"name":"Department of Clinical Laboratory , Yixing Hospital of Traditional Chinese Medicine, Yixing , Jiangsu , PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology , College of Basic Medical Sciences , China Medical University , Shenyang , PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya Li","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology , College of Basic Medical Sciences , China Medical University , Shenyang , PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan Dan","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology , College of Basic Medical Sciences , China Medical University , Shenyang , PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2018,10,22]]},"reference":[{"key":"2022042708342991444_j_med-2018-0071_ref_001_w2aab3b7b2b1b6b1ab2b2b1Aa","doi-asserted-by":"crossref","unstructured":"Park KH, Kim ES, Kim HS, Park SJ, Bang KM, Park HJ, et al. 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