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Updated: Jun 22, 2025
Development and Assessment of Intracellular Infection Models for Staphylococcus aureus
Published on: January 17, 2025
The Complex Intracellular Lifecycle of Staphylococcus aureus Contributes to Reduced Antibiotic Efficacy and
Cecilia F Volk1, Richard A Proctor2,3, Warren E Rose1,2
1Pharmacy Practice and Translational Research Division, School of Pharmacy, Pharmacy University of Wisconsin-Madison, Madison, WI 53705, USA.
Abstract:
Staphylococcus aureus bacteremia continues to be associated with significant morbidity and mortality, despite improvements in diagnostics and management. Persistent infections pose a major challenge to clinicians and have been consistently shown to increase the risk of mortality and other infectious complications. S. aureus, while typically not considered an intracellular pathogen, has been proven to utilize an intracellular niche, through several phenotypes including small colony variants, as a means for survival that has been linked to chronic, persistent, and recurrent infections. This intracellular persistence allows for protection from the host immune system and leads to reduced antibiotic efficacy through a variety of mechanisms. These include antimicrobial resistance, tolerance, and/or persistence in S. aureus that contribute to persistent bacteremia. This review will discuss the challenges associated with treating these complicated infections and the various methods that S. aureus uses to persist within the intracellular space.
Insights
Staphylococcus aureus bacteremia can persist by hiding inside host cells, evading immune responses and antibiotics. This intracellular survival mechanism contributes to treatment challenges and increased mortality risk in persistent S. aureus infections.
Area of Science:
- Microbiology
- Infectious Diseases
- Pathogenesis
Background:
- Staphylococcus aureus bacteremia causes significant morbidity and mortality.
- Persistent S. aureus infections increase mortality and infectious complications.
- S. aureus can survive intracellularly, leading to chronic and recurrent infections.
Purpose of the Study:
- To review the challenges in treating persistent S. aureus infections.
- To discuss the intracellular survival mechanisms of S. aureus.
- To highlight how intracellular persistence impacts treatment efficacy.
Main Methods:
- Literature review of studies on Staphylococcus aureus intracellular survival.
- Analysis of S. aureus phenotypes contributing to persistence (e.g., small colony variants).
- Examination of mechanisms of immune evasion and antibiotic resistance.
Main Results:
- S. aureus utilizes intracellular niches for survival, protected from host immunity.
- Intracellular persistence is linked to small colony variants and other phenotypes.
- This persistence contributes to antimicrobial resistance, tolerance, and reduced antibiotic efficacy.
Conclusions:
- Intracellular persistence is a key challenge in treating S. aureus bacteremia.
- Understanding these mechanisms is crucial for developing effective treatment strategies.
- Targeting intracellular S. aureus may improve outcomes for persistent infections.
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