This unique combination of genetic characteristics suggests that SaPI68111 probably arose following at least one major recombination event with several SaPIs or other similar elements, whereas the regulatory gene (e.g., stl gene) might be acquired by S. aureus through horizontal transfer from other species (e.g., Staphylococcus haemolyticus) during co-colonization or infections. Here, RNF217-AS1 is linked to infection.