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Background  There have been no reports regarding the molecular characteristics, virulence features, and antibiotic resistance profiles of  Staphylococcus aureus  ( S. aureus ) from Hainan, the southernmost province of China.    Methods  Two hundred twenty-seven  S. aureus  isolates, consisting of 76 methicillin-resistant  S. aureus  (MRSA) and 151 methicillin-susceptible  S. aureus  (MSSA), were collected in 2013–2014 and 2018–2019 in Hainan, and investigated for their molecular characteristics, virulence genes, antibiotic resistance profiles and main antibiotic resistance genes.    Results  Forty sequence types (STs) including three new STs (ST5489, ST5492 and ST5493), and 79 Staphylococcal protein A ( spa ) types were identified based on multilocus sequence typing (MLST) and  spa  typing, respectively. ST398 (14.1%, 32/227) was found to be the most prevalent, and the prevalence of ST398-MSSA increased significantly from 2013 to 2014 (5.5%, 5/91) to 2018–2019 (18.4%, 25/136). Seventy-six MRSA isolates were subject to staphylococcus chromosomal cassette  mec  (SCC mec ) typing. SCC mec- IVa was the predominant SCC mec  type, and specifically, ST45-SCC mec  IVa, an infrequent type in mainland China, was predominant in  S. aureus  from Hainan. The antibiotic resistance profiles and antibiotic resistance genes of  S. aureus  show distinctive features in Hainan. The resistant rates of the MRSA isolates to a variety of antibiotics were significantly higher than those of the MSSA isolates. The predominant erythromycin and tetracycline resistance genes were  ermC  (90.1%, 100/111) and  tetK  (91.8%, 78/85), respectively. Eleven virulence genes, including the Panton-Valentine leukocidin ( pvl ) and  eta , were determined, and the frequency of  eta  and  pvl  were found to be 57.3 and 47.6%. Such high prevalence has never been seen in mainland China before.    Conclusion   S. aureus  isolates in Hainan have unique molecular characteristics, virulence gene and antibiotic resistance profiles, and main antibiotic resistance genes which may be associated with the special geographical location of Hainan and local trends in antibiotic use.

Molecular characteristics and virulence gene profiles of Staphylococcus aureus isolates in Hainan, China