The transcription of mecA, the gene required for oxacillin resistance in staphylococci, was quantified in a collection of 65 geographically and genetically diverse clinical and 8 defined laboratory Staphylococcus aureus isolates. mecA transcription was measured by real-time reverse transcription-PCR, confirmed by Northern blot analysis, and correlated with the presence and DNA sequence of the two mecA repressors, mecI and blaI. Isolates were first examined that contained mecI and/or blaI with wild-type sequence. BlaI provided significantly more repression of mecA transcription than did MecI, unrelated to blaI genetic location. Both together repressed mecA better than either one alone. In clinical isolates containing only wild-type mecI, mecA transcription repression was 10-to 25-fold less effective than that seen in previously studied constructs derived from strain N315. There was a difference in the mecI ribosomal binding site (RBS) between the clinical isolates (GGAA) and N315 (GGAG). The GGAA RBS was associated with 5.5-to 7.3-fold less mecA repression than GGAG in isogenic constructs. The values generated for wild-type repressors were compared to those in 26 isolates containing mecI mutations. mecA transcription appeared to be repressed only by BlaI in isolates with mecI nonsense and frameshift mutations. In contrast, mecI repression seemed to be partially or fully retained in many of the isolates with mecI and one isolate with blaI missense mutations, providing structure-function correlates with the site and type of mutation. We conclude that mecA repressor activity is highly variable in clinical S. aureus isolates due to mecI mutations, RBS polymorphisms, and unidentified genomic adaptations.Two repressors, BlaI and/or MecI, regulate transcription of mecA, the gene required for oxacillin resistance in staphylococci (8,15). mecA encodes a penicillin binding protein (PBP2a) that is poorly bound by -lactam antibiotics and can perform essential functions of cell wall construction when -lactams inactivate the cell's normal penicillin binding protein complement (3,14). Two signal transducers, BlaR1 and MecR1, regulate repressor activity (20). MecR1 and BlaR1 are transmembrane -lactam sensory transducers, having a surface-exposed -lactam binding domain and a cytoplasmic zinc peptidase motif. Signal transduction is thought to occur following interaction of a -lactam antibiotic with the binding domain, transmitting a signal through four membrane-spanning segments. This induces conformational change in the cytoplasmic metalloprotease domain causing autoproteolysis. Proteolytic cleavage of the inducer is followed by cleavage of the repressor, leading to derepression of target genes. The genes for signal transducers and repressors are contained in two-gene operons (blaR1-blaI and mecR1-mecI) that are divergently transcribed from their regulated genes (blaZ and mecA, respectively) (8, 13, 15). The repressors bind to specific palindromic sequences that overlap divergent promoters for mecA and mecR1 (8,18). A helix-...