Persistent and relapsing infections associated with small-colony variants of staphylococcus aureus

Richard A. Proctor, Petra Van Langevelde, Mar Kristjansson, Joel N. Maslow, Robert D. Arbeit

Research output: Contribution to journalArticlepeer-review

336 Scopus citations


Small-colony variants (SCVs) of Staphylococcus aureus were cultured from five patients with persistent and relapsing infections. All five SCV strains were nonhemolytic and nonpigmented and grew very slowly on routine culture media in an ambient atmosphere. In several instances, these phenotypic characteristics led to the initial misidentification of the organisms in the clinical microbiology laboratory. All four strainsavailable for further analysis were shown to be auxotrophs that reverted to normal growth and morphology in the presence of menadione, hemin, and/or a CO2 supplement. Similarly, these isolates were resistant to aminoglycosides under routine conditions but susceptible in the presence of the metabolic supplements. For two patients, the large and small colony forms isolatedconcurrently were indistinguishable when analyzed by pulsed field gel electrophoresis and thus represented phenotypic variants within individualclones. We propose a model relating the phenotypic characteristics of S. aureus SCVs with the clinical pattern of persistent and relapsing infection.

Original languageEnglish (US)
Pages (from-to)95-102
Number of pages8
JournalClinical Infectious Diseases
Issue number1
StatePublished - Jan 1995

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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