Scheme of dynamic SCV development in the course from acute to chronic infection. Scheme of dynamic SCV development in the course from acute to chronic.

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Scheme of dynamic SCV development in the course from acute to chronic infection. Scheme of dynamic SCV development in the course from acute to chronic infection. During acute infection, bacteria show high-level expression of agr and regulated toxins causing inflammatory and cytotoxic reactions. In the chronic course of the infection, bacteria apply adaptation mechanisms to resist cellular degradation that involve formation of dynamic SCV-like phenotypes, downregulation of agr, and upregulation of SigB. When leaving the intracellular shelter, the SCVs can rapidly revert back to the fully aggressive wild-type phenotype, which can cause a new episode of infection. Barbara C. Kahl et al. Clin. Microbiol. Rev. 2016; doi:10.1128/CMR.00069-15