Staphylococcus aureus is the second leading cause of bacteremia worldwide and the most important pathogen in endovascular infections (1, 2). S. aureus has a particular propensity for developing multidrug resistance (e.g., methicillin-resistant S. aureus [MRSA] and vancomycin-intermediate S. aureus [VISA]), and serious infections with such strains result in enhanced attributable mortality (3).Since its FDA approval in 2003, daptomycin (DAP) has been utilized in many clinical settings, especially for recalcitrant MRSA infections, such as endocarditis (4-6). However, there have been a number of recently reported cases of clinical S. aureus strains that have evolved in vitro DAP resistance in the context of failing DAP treatment regimens, especially in endovascular syndromes. (Note that although the official term is daptomycin nonsusceptibility, we use the term daptomycin resistance in this paper for ease of presentation [7][8][9][10][11][12].) One of the major features of DAP-resistant (DAP r ) S. aureus strains is the acquisition of gain-in-function mutations in a relatively restricted cadre of genes, especially in the mprF locus (13-18). The MprF protein is responsible for the synthesis and translocation (flipping) of the unique positively charged phospholipid (PL) lysyl-phosphotidylglycerol (L-PG) from the inner-to-outer cell membrane (CM) leaflet (18)(19)(20). Increases in L-PG synthesis and flipping usually result in augmented positive surface charge; many investigators have speculated that this event leads to a charge-repulsive milieu for cationic molecules, such as host defense peptides (HDPs) and calcium-complexed DAP (13,(19)(20)(21)(22)(23). Over the past several years, a number of laboratories, including ours, have linked the presence of singlenucleotide polymorphisms (SNPs) within the mprF locus to the DAP r phenotype (13,14, 21,(24)(25)(26). These SNPs have occurred throughout the mprF open reading frame (ORF), although there are clearly hot spots within this locus for those SNPs linked to DAP resistance (13,14,19, 23). Investigations of mprF SNPs associated with DAP resistance in S. aureus have principally emerged from studies that used only a few or individual isogenic DAP-susceptible (DAP s ) and DAP r strain pairs. To address this limitation, in the current study, we assessed (i) the frequencies and distribution of putative mprF gain-in-function SNPs using 22 DAP s /DAP r isogenic clinical MRSA strain pairs, (ii) the relation-