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Early cystic fibrosis (CF) airway infections start with\n                      <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">SA<\/jats:italic>\n                      ), often later followed by\n                      <jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">PA<\/jats:italic>\n                      ) infections. In this study, we have evaluated the role of\n                      <jats:italic toggle=\"yes\">SA<\/jats:italic>\n                      pumps NorA and Tet38 in survival and interaction with\n                      <jats:italic toggle=\"yes\">PA<\/jats:italic>\n                      in CF patients. Data showed a \u22654-log\n                      <jats:sub>10<\/jats:sub>\n                      CFU\/mL growth deficit of\n                      <jats:italic toggle=\"yes\">SA<\/jats:italic>\n                      mutants\n                      <jats:italic toggle=\"yes\">\u0394norA<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">\u0394tet38<\/jats:italic>\n                      in an artificial sputum medium (ASM), suggesting NorA and Tet38 contributed to\n                      <jats:italic toggle=\"yes\">SA<\/jats:italic>\n                      growth in CF sputum. In ASM, mucin activated\n                      <jats:italic toggle=\"yes\">norA<\/jats:italic>\n                      but inhibited\n                      <jats:italic toggle=\"yes\">tet38,<\/jats:italic>\n                      while extracellular DNA activated\n                      <jats:italic toggle=\"yes\">tet38<\/jats:italic>\n                      but inhibited\n                      <jats:italic toggle=\"yes\">norA<\/jats:italic>\n                      , demonstrating complementary roles of mucin and DNA in affecting NorA and Tet38 expression. Furthermore, exposure of\n                      <jats:italic toggle=\"yes\">SA<\/jats:italic>\n                      wild type to\n                      <jats:italic toggle=\"yes\">PA<\/jats:italic>\n                      -excreted molecules affected pump expression; 3,4-dihydroxy-2-heptylquinoline PQS caused an increase in\n                      <jats:italic toggle=\"yes\">tet38<\/jats:italic>\n                      but a decrease in\n                      <jats:italic toggle=\"yes\">norA<\/jats:italic>\n                      , 4-hydroxy-2-heptylquinoline HHQ caused a decrease in\n                      <jats:italic toggle=\"yes\">norA<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">tet38<\/jats:italic>\n                      , and pyocyanin PYO caused a modest increase in\n                      <jats:italic toggle=\"yes\">norA<\/jats:italic>\n                      , demonstrating differing additional roles of\n                      <jats:italic toggle=\"yes\">PA<\/jats:italic>\n                      -secreted molecules influencing NorA and Tet38 expression. Evaluation of 48 randomly selected unique CF-associated\n                      <jats:italic toggle=\"yes\">SA<\/jats:italic>\n                      showed that 18.8% were NorA-overexpressors and 10.4% were Tet38-overexpressors. NorA-overexpressors showed a fourfold increase in pyocyanin MIC and \u226516-fold in ciprofloxacin MIC. Furthermore, 89% of NorA-overexpressors carried an insertion of CAAT\/ACAA\/CTAT at the (\u221210) motif of the\n                      <jats:italic toggle=\"yes\">norA<\/jats:italic>\n                      promoter, and 62.5% of these were co-isolated with\n                      <jats:italic toggle=\"yes\">PA<\/jats:italic>\n                      .\n                    <\/jats:p>\n                    <jats:p>\n                      These data showed that\n                      <jats:italic toggle=\"yes\">SA<\/jats:italic>\n                      survives\n                      <jats:italic toggle=\"yes\">PA<\/jats:italic>\n                      killing in CF sputum conditions using sputum key components and\n                      <jats:italic toggle=\"yes\">PA<\/jats:italic>\n                      -specific signal molecules to regulate NorA and Tet38 expression.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.00460-25","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T13:45:26Z","timestamp":1752068726000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":4,"title":["NorA and Tet38 efflux pumps enable\n                    <i>Staphylococcus aureus<\/i>\n                    survival in the cystic fibrosis airway environment, resistance to antibiotics, and coinfection with\n                    <i>Pseudomonas aeruginosa<\/i>"],"prefix":"10.1128","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3275-4360","authenticated-orcid":true,"given":"Q. C.","family":"Truong-Bolduc","sequence":"first","affiliation":[{"name":"Infectious Diseases Division and Medical Services, Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Wang","sequence":"additional","affiliation":[{"name":"Infectious Diseases Division and Medical Services, Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. G.","family":"Lawton","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. J.","family":"Zweifach","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. M.","family":"McDevitt","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"El Abdellaoui","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Brown Harding","sequence":"additional","affiliation":[{"name":"Infectious Diseases Division and Medical Services, Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1711-8227","authenticated-orcid":true,"given":"L. M.","family":"Yonker","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. G.","family":"Rahme","sequence":"additional","affiliation":[{"name":"Department of Surgery, Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. M.","family":"Vyas","sequence":"additional","affiliation":[{"name":"Infectious Diseases Division and Medical Services, Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1444-9939","authenticated-orcid":false,"given":"D. 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