Small colony variants of staphylococci: Pathogenesis and evolutionary significance in causing and sustaining problematic human infections

Background. Small colony variants have been implicated as the cause of several chronic disease states unmanageable by antibiotic therapy. Thus, this review evaluates the mechanisms employed by this subpopulation in the propagation of nosocomial infections involving the staphylococcal species. Furthermore, we propose several hypotheses for the evolutionary role this phenotype may play in clinical settings.Results. Research suggests that a combined effort of certain auxotrophies contributes to a reduced metabolic rate within small colony variant bacteria. This minimizes the effect of antibiotics used against them and allows this phenotype to endure as an intracellular infection. Additionally, numerous studies have suggested that perhaps these variants alter the mechanisms of the immune system that are normally fashioned against such invasive pathogens. Studies have shown that although these variants possess reduced virulence factors compared with parental strains, they exhibit an increased ability to attach...