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S. aureus small colony variants

Question
We just received the sputum culture of our 7yr old daughter, which showed the presence of S. aureus and S. aureus small colony variants. What is the meaning of small colony variants? Should we treat these colonies? Is it a classical evolution of S. aureus?
Answer
Small colony variants of S. aureus are present in up to 25% in the sputum of patients with CF, but many laboratory do no test for their presence. It has been suggested that the presence of S. aureus small colony variants was associated with worsening of lung function outcome, but very little data exists on treatment strategies. The decision of treating or not treating should be based on your physician's assessment: it depends on whether the infection is acute or chronic and whether you child has symptoms of an exacerbation or not.
Best regards,
Dr. Burgel
02.01.2017