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2016 ; 29
(2
): 401-27
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Clinical Significance and Pathogenesis of Staphylococcal Small Colony Variants in
Persistent Infections
#MMPMID26960941
Kahl BC
; Becker K
; Löffler B
Clin Microbiol Rev
2016[Apr]; 29
(2
): 401-27
PMID26960941
show ga
Small colony variants (SCVs) were first described more than 100 years ago for
Staphylococcus aureus and various coagulase-negative staphylococci. Two decades
ago, an association between chronic staphylococcal infections and the presence of
SCVs was observed. Since then, many clinical studies and observations have been
published which tie recurrent, persistent staphylococcal infections, including
device-associated infections, bone and tissue infections, and airway infections
of cystic fibrosis patients, to this special phenotype. By their intracellular
lifestyle, SCVs exhibit so-called phenotypic (or functional) resistance beyond
the classical resistance mechanisms, and they can often be retrieved from
therapy-refractory courses of infection. In this review, the various clinical
infections where SCVs can be expected and isolated, diagnostic procedures for
optimized species confirmation, and the pathogenesis of SCVs, including defined
underlying molecular mechanisms and the phenotype switch phenomenon, are
presented. Moreover, relevant animal models and suggested treatment regimens, as
well as the requirements for future research areas, are highlighted.