Growth and conversion to the mucoid phenotype by nonmucoid Pseudomonas aeruginosa PAO1 was studied in a chemostat system under conditions designed to reflect those likely to be present during chronic infection in the lung in cystic fibrosis patients. Mucoid variants were consistently isolated during continuous culture in the presence of 0.3 M NaCl or 5 or 10% glycerol. Mucoid subpopulations were also detected under conditions of carbon, nitrogen, or phosphate limitation. During carbon or nitrogen limitation, mucoid conversion was dependent upon the choice of substrate. Phosphate-limited cultures exhibited an inverse relationship between culture growth rate and number of mucoid organisms detected. Mucoid variants were not detected when dilution rates (D) exceeded 0.173 h-'. Conversely, at a D of 0.044 h-1, 40% of the population expressed the mucoid phenotype. Phosphorylcholine, a product of phosphojipase C activity on the major lung surfactant phosphatidylcholine, was also used as a growth substrate in nutrient limitation studies. Under all conditions, growth of PAO1 supplied with phosphorylcholine resulted in isolation of mucoid variants, indicating that the lung may provide at least one nutrient source conducive to mucoid conversion. Continuous culture also resulted in detection of a phage associated with strain PAO1. High titers of phage were present under all conditions, including those which yielded no mucoid organisms, suggesting that environmental conditions rather than the phage regulated the appearance of mucoid variants.Pseudomonas aeruginosa is responsible for much of the morbidity and mortality associated with chronic pulmonary infections in cystic fibrosis (CF) patients (10,15,24). With prolonged chronic infection, P. aeruginosa undergoes alteration from the classical nonmucoid form to an atypical mucoid form, which correlates with the production of the exopolysaccharide alginic acid (6). In the context of chronic lung infection, alginate is an important virulence determinant. The appearance of alginate-producing P. aeruginosa strains is usually associated with a poor patient prognosis (10). Alginate has been implicated in adherence to tracheal epithelium (21, 28) and has been associated with antiphagocytic function (29). While the relationship between mucoid P. aeruginosa and CF is well documented, the environmental factors of the CF lung responsible for conversion of nonmucoid P. aeruginosa to the alginate-producing mucoid form have yet to be defined.A chemostat model for the study of this organism under chronic diseaselike growth conditions (phosphate and nitrogen limitation) which would reflect the likely physiological status of organisms in the lungs of CF patients has recently been reported (18). In this study, phosphate-limited cultures of mucoid P. aeruginosa were capable of utilizing phosphorylcholine (PC), a product of phospholipase C activity on phosphatidylcholine (a major component of lung surfactant), as a sole source of phosphate for growth (18).In an effort to understand the environmen...