Staphylococcus aureus phenotype switching: an effective bacterial strategy to escape host immune response and establish a chronic infection

By L. Tuchscherr, E. Medina, M. Hussain, W. Völker, Vanessa Heitmann, S. Niemann, D. Holzinger, J. Roth, R. Proctor, K. Becker and 2 more. 2011

440 citations recorded by the source corpus.

Staphylococcus aureus is a frequent cause for serious, chronic and therapy‐refractive infections in spite of susceptibility to antibiotics in vitro. In chronic infections, altered bacterial phenotypes, such as small colony variants (SCVs), have been found. Yet, it is largely unclear whether the ability to interconvert from the wild‐type to the SCV phenotype is only a rare clinical and/or just laboratory phenomenon or is essential to sustain an infection. Here, we performed different long‐term in vitro and in vivo infection models with S. aureus and we show that viable bacteria can persist within host cells and/or tissues for several weeks. Persistence induced bacterial phenotypic diversity, including SCV phenotypes, accompanied by changes in virulence factor expression and auxotrophism. However, the recovered SCV phenotypes were highly dynamic and rapidly reverted to the fully virulent wild‐type form when leaving the intracellular location and infecting new cells. Our findings demonstrate that bacterial phenotype switching is an integral part of the infection process that enables the bacteria to hide inside host cells, which can be a reservoir for chronic and therapy‐refractive infections.

Subfields: Genetics, Infectious Diseases, Molecular Biology

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Citations in the corpus

Intracellular staphylococcus aureus: Live-in and let die (2012, positive): “…phagocytes or endothelial cells for prolonged periods (Hamill et al., 1986; Lowy et al., 1988; Vann and Proctor, 1988; Buisman et al., 1991; Hiemstra et al., 1992; Schröder et al., 2006a; Garzoni et al., 2007; Kubica et al., 2008; Tuchscherr et al., 2011; reviewed in Sendi and Proctor, 2009).”
Antibiotic resistance and persistence—Implications for human health and treatment perspectives (2020, positive): “However, most small colonies recovered in vitro , directly from patient material in clinical microbiology laboratories or from murine infection models revert to a normal colony size upon subcultivation (Tuchscherr et al , 2011; Vulin et al , 2018).”
Identification and treatment of the Staphylococcus aureus reservoir in vivo (2016, positive): “Studies dating back over half a century have shown that S. aureus can survive in vitro in endothelial cells, epithelial cells, osteoclasts, and even in professional phagocytes such as neutrophils and macrophages (Rogers, 1956; Gresham et al., 2000; Koziel et al., 2009; Tuchscherr et al., 2011).”