{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T04:24:11Z","timestamp":1784953451105,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,3,16]],"date-time":"2020-03-16T00:00:00Z","timestamp":1584316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Small\u2010colony variants (SCVs) are a morphologic subtype of <jats:italic>Staphylococcus aureus<\/jats:italic> that may occur through several mechanisms including auxotrophism for thymidine, hemin, or menadione. Auxotrophic SCV for thymidine fail to synthesize DNA specifically because of mutations in the thymidylate synthase gene. We isolated <jats:italic>S. aureus<\/jats:italic> thymidine\u2010dependent SCVs (TD\u2010SCV) from blood and respiratory samples of a pediatric patient with cystic fibrosis and pulmonary exacerbation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Nutritional dependence of SCVs on hemin, menadione, and thymidine was evaluated. Antimicrobial susceptibility testing was performed through broth microdilution. Polymerase chain reaction was carried out for <jats:italic>mec<\/jats:italic>A, <jats:italic>erm<\/jats:italic>A, <jats:italic>erm<\/jats:italic>B, <jats:italic>erm<\/jats:italic>C, <jats:italic>msr<\/jats:italic>A, <jats:italic>and msr<\/jats:italic>B resistance genes. DNA sequencing was used to determine mutations in <jats:italic>thyA<\/jats:italic> and the multilocus sequence typing to identify genetic relatedness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Methicillin\u2010sensitive <jats:italic>S. aureus<\/jats:italic> with normal and TD\u2010SCV phenotypes were isolated from respiratory samples and a TD\u2010SCV phenotype was isolated from blood culture. Macrolides resistance was attributed to <jats:italic>ermC<\/jats:italic> and <jats:italic>msr<\/jats:italic>B genes. All isolates belonged to ST398. The <jats:italic>thy<\/jats:italic>A gene in <jats:italic>S. aureus<\/jats:italic> is 957 nucleotides in length and encodes a protein of 318 amino acids. The TD\u2010SCV isolates carried a \u22122\u2009nt frameshift mutation (delta 667GC668) in <jats:italic>thy<\/jats:italic>A, creating a stop codon at residue 222 close to the predicted binding site for deoxyuridine monophosphate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The pathogenesis of SCVs is complex and not fully elucidated. Factors inherent to the patient such as physiological conditions, recurrent infections, or coinfection should be considered. Although SCVs are considered less virulent, they showed the ability to invade and cause bacteremia in the patient.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.24730","type":"journal-article","created":{"date-parts":[[2020,3,16]],"date-time":"2020-03-16T17:39:36Z","timestamp":1584380376000},"page":"1388-1393","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Thymidine\u2010auxotrophic <i>Staphylococcus aureus<\/i> small\u2010colony variant bacteremia in a patient with cystic fibrosis"],"prefix":"10.1002","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3095-5273","authenticated-orcid":false,"given":"Dilair C.","family":"de Souza","sequence":"first","affiliation":[{"name":"Laborat\u00f3rio de Bacteriologia Complexo Hospital de Cl\u00ednicas, Universidade Federal do Paran\u00e1 Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura L.","family":"Cogo","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Bacteriologia Complexo Hospital de Cl\u00ednicas, Universidade Federal do Paran\u00e1 Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jussara K.","family":"Palmeiro","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s\u2010gradua\u00e7\u00e3o em Biotecnologia e sa\u00fade da Crian\u00e7a e do Adolescente Faculdades e Instituto de Pesquisa Pel\u00e9 Pequeno Pr\u00edncipe  Curitiba Brazil"},{"name":"Departamento de An\u00e1lises Cl\u00ednicas Centro de Ci\u00eancias da Sa\u00fade Universidade Federal de Santa Catarina Florian\u00f3polis Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Libera M.","family":"Dalla\u2010Costa","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s\u2010gradua\u00e7\u00e3o em Biotecnologia e sa\u00fade da Crian\u00e7a e do Adolescente Faculdades e Instituto de Pesquisa Pel\u00e9 Pequeno Pr\u00edncipe  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana P.","family":"de Oliveira Tomaz","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Bacteriologia Complexo Hospital de Cl\u00ednicas, Universidade Federal do Paran\u00e1 Curitiba Brazil"},{"name":"Programa de P\u00f3s\u2010gradua\u00e7\u00e3o em Biotecnologia e sa\u00fade da Crian\u00e7a e do Adolescente Faculdades e Instituto de Pesquisa Pel\u00e9 Pequeno Pr\u00edncipe  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos A.","family":"Riedi","sequence":"additional","affiliation":[{"name":"Departamento de Pediatria Complexo Hospital de Cl\u00ednicas, Universidade Federal do Paran\u00e1 Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8550-8051","authenticated-orcid":false,"given":"Nelson A.","family":"Rosario Filho","sequence":"additional","affiliation":[{"name":"Departamento de Pediatria Complexo Hospital de Cl\u00ednicas, Universidade Federal do Paran\u00e1 Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,3,16]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Cystic Fibrosis Foundation.Patient Registry 2017 Annual Data Report.Bethesda MD:Cystic Fibrosis 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