Proctor R A, Kahl B, von Eiff C, Vaudaux P E, Lew D P, Peters G
Institute of Medical Microbiology, University of Muenster, Germany.
Clin Infect Dis. 1998 Aug;27 Suppl 1:S68-74. doi: 10.1086/514906.
Over the past 4 years, a variant subpopulation of Staphylococcus aureus has been characterized that is defective in electron transport. These organisms grow slowly and are typical of the previously described small colony variants (SCVs). Indeed, many earlier papers included data that are consistent with defective respiratory activity in SCVs. We present a hypothesis that serves as biochemical basis for the development of SCVs. These variants are particularly interesting because they have been associated with very persistent infections, and they are more resistant to many antibiotics than normal S. aureus. Because of their slow growth, atypical colonial morphology, and unusual biochemical profile, they are easily missed or misidentified in the clinical laboratory. This is of some significance, as this subpopulation is more resistant to antibiotics than the parent population from which they arose. When an infection is particularly resistant to therapy, persists for a long period, or fails to respond to apparently adequate antimicrobial therapy, clinicians and clinical laboratory personnel should consider special efforts to search for SCVs.
在过去4年里，已鉴定出一种金黄色葡萄球菌的变异亚群，其电子传递存在缺陷。这些微生物生长缓慢，是先前描述的小菌落变异株（SCV）的典型特征。实际上，许多早期论文所包含的数据与SCV中呼吸活性缺陷是一致的。我们提出一种假说，作为SCV形成的生化基础。这些变异株特别有趣，因为它们与非常持久的感染有关，并且比正常金黄色葡萄球菌对许多抗生素更具抗性。由于它们生长缓慢、具有非典型的菌落形态以及不寻常的生化特征，在临床实验室中很容易被漏检或误认。这具有一定意义，因为这个亚群比产生它们的亲代群体对抗生素更具抗性。当感染对治疗特别耐药、持续很长时间或对明显足够的抗菌治疗无反应时，临床医生和临床实验室人员应特别努力寻找SCV。
