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In this study, we assessed the development of\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    tolerance to these phototreatments. Reference\n                    <jats:italic>S<\/jats:italic>\n                    .\n                    <jats:italic>aureus<\/jats:italic>\n                    USA300 JE2 was subjected to 15 cycles of both sub-lethal aPDI (employing an exogenously administered photosensitizer (PS), i.e., rose Bengal (RB)) and sub-lethal aBL (employing endogenously produced photosensitizing compounds, i.e., porphyrins). We demonstrate substantial aPDI\/aBL tolerance development and tolerance stability after 5 cycles of subculturing without aPDI\/aBL exposure (the development of aPDI\/aBL tolerance was also confirmed with the employment of clinical MRSA and MSSA strain as well as other representatives of Gram-positive microbes, i.e.\n                    <jats:italic>Enterococcus faecium<\/jats:italic>\n                    and\n                    <jats:italic>Streptococcus agalactiae<\/jats:italic>\n                    ). In addition, a rifampicin-resistant (RIF\n                    <jats:sup>R<\/jats:sup>\n                    ) mutant selection assay showed an increased mutation rate in\n                    <jats:italic>S<\/jats:italic>\n                    .\n                    <jats:italic>aureus<\/jats:italic>\n                    upon sub-lethal phototreatments, indicating that the increased aPDI\/aBL tolerance may result from accumulated mutations. Moreover, qRT-PCR analysis following sub-lethal phototreatments demonstrated increased expression of\n                    <jats:italic>umuC<\/jats:italic>\n                    , which encodes stress-responsive error-prone DNA polymerase V, an enzyme that increases the rate of mutation. Employment of\n                    <jats:italic>recA<\/jats:italic>\n                    and\n                    <jats:italic>umuC<\/jats:italic>\n                    transposon\n                    <jats:italic>S<\/jats:italic>\n                    .\n                    <jats:italic>aureus<\/jats:italic>\n                    mutants confirmed SOS-induction dependence of the tolerance development. Interestingly, aPDI\/aBL-tolerant\n                    <jats:italic>S<\/jats:italic>\n                    .\n                    <jats:italic>aureus<\/jats:italic>\n                    exhibited increased susceptibility to gentamicin (GEN) and doxycycline (DOX), supporting the hypothesis of genetic alterations induced by sub-lethal phototreatments. The obtained results indicate that\n                    <jats:italic>S<\/jats:italic>\n                    .\n                    <jats:italic>aureus<\/jats:italic>\n                    may develop stable tolerance to studied phototreatments upon sub-lethal aPDI\/aBL exposure; thus, the risk of tolerance development should be considered significant when designing aPDI\/aBL protocols for infection treatments\n                    <jats:italic>in vitro<\/jats:italic>\n                    and in clinical settings.\n                  <\/jats:p>","DOI":"10.1038\/s41598-019-45962-x","type":"journal-article","created":{"date-parts":[[2019,7,1]],"date-time":"2019-07-01T06:03:09Z","timestamp":1561960989000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":94,"title":["Development of Staphylococcus aureus tolerance to antimicrobial photodynamic inactivation and antimicrobial blue light upon sub-lethal treatment"],"prefix":"10.1038","volume":"9","author":[{"given":"Aleksandra","family":"Rapacka-Zdonczyk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agata","family":"Wozniak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Pieranski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Woziwodzka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5812-6314","authenticated-orcid":false,"given":"Krzysztof P.","family":"Bielawski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4041-0891","authenticated-orcid":false,"given":"Mariusz","family":"Grinholc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,7,1]]},"reference":[{"key":"45962_CR1","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.mib.2016.06.008","volume":"33","author":"MR Hamblin","year":"2016","unstructured":"Hamblin, M. 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