Adaptation of Staphylococcus aureus to Airway Environments in Patients With Cystic Fibrosis by Upregulation of Superoxide Dismutase M and Iron-Scavenging Proteins

Staphylococcus aureus represents an important pathogen in patients with cystic fibrosis (CF), owing to its early and persistent colonization of airways for extended periods. Although the median predicted survival age of patients with CF has increased during the last decade, pulmonary infections are still a challenge. In this study, we investigated the adaptation of S. aureus isolates cultured from airway specimens of a patient with CF by comparing the proteome of the first and latest available isolate, recovered 13 years apart. Our data revealed changes in the abundance of proteins involved in energy metabolism, cellular processes, transport, and binding. Most importantly, these changes resulted in an iron-scavenging phenotype and increased activity of superoxide dismutase M, with most changes probably facilitating the long-term persistence of S. aureus in the airways of individuals with CF. Our results underscore the potential of S. aureus for niche adaptation during long-term persistence within the hostile airway environment of individuals with CF.