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The nutrient-rich milk environment supports bacterial growth, but the specific genetic determinants that facilitate <jats:italic>S. aureus<\/jats:italic> proliferation and persistence in milk are poorly understood. In this study, we conducted a genome-wide CRISPR interference sequencing (CRISPRi-seq) screen with the laboratory strain <jats:italic>S. aureus<\/jats:italic> NCTC8325\u20134, to identify fitness determinants essential for <jats:italic>S. aureus<\/jats:italic> growth and survival in milk. We identified 282 milk-essential genes, including those with key roles in DNA replication, protein synthesis, and metabolism. Comparative analysis with brain heart infusion (BHI) as growth medium, revealed 79 genes with differential fitness, highlighting specific adaptations required for growth in milk. Notably, we found that purine biosynthesis, folate cycle pathways, and metal acquisition were particularly important in this environment. Based on this, we further demonstrate that <jats:italic>S. aureus<\/jats:italic> is more sensitive to the folate inhibitors trimethoprim-sulfamethoxazole (TMP-SMX) in milk and identify several genes whose knockdown results in hypersensitivity to TMP-SMX in milk. Additionally, our analysis showed a relatively reduced importance of cell wall components, such as teichoic acids, for <jats:italic>S. aureus<\/jats:italic> fitness in milk, which is also reflected in reduced efficiency of antimicrobials targeting teichoic acids. Together, these findings provide new insights into the genetic basis of <jats:italic>S. aureus<\/jats:italic> fitness and antibiotic susceptibility in milk, offering directions for novel treatment strategies against bovine mastitis.<\/jats:p>","DOI":"10.1371\/journal.ppat.1013080","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T17:43:02Z","timestamp":1744220582000},"page":"e1013080","update-policy":"https:\/\/doi.org\/10.1371\/journal.ppat.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Genome-wide analysis of fitness determinants of Staphylococcus aureus during growth in milk"],"prefix":"10.1371","volume":"21","author":[{"given":"Marita Torrissen","family":"M\u00e5rli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Olsdatter 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