“…Development of new metabolic capacities can nonetheless arise through enrichment of the accessory genome in metabolic functions [17,28,60]. This adjusted metabolism increases P. aeruginosa fitness in the CF environment, but it often results in a slowed growth in laboratory conditions in comparison to nonadapted isolates [7,8,12,13,18,107,110,114]. This modification of metabolic activities can limit effective detection and treatment of infecting P. aeruginosa, as illustrated by the emergence of highly resistant small colony variants (SCVs) and viable but non-culturable (VBNC) isolates [115][116][117].…”