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Clinical data were collected, and patients with single versus recurrent SCV detections were compared to identify risk factors for recurrent SCVs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 154 pwCF (62 children, 92 adults), SCV was detected in 38.31%. Univariate analysis identified lower percent predicted forced expiratory volume in the first second (ppFEV\n                      <jats:sub>1<\/jats:sub>\n                      ) (OR: 0.49,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04), prior trimethoprim-sulfamethoxazole (TMP-SMX) use (OR: 2.639,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), chronic azithromycin (OR: 2.228,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.020), and chronic\/intermittent\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      colonisation (OR: 2.107,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.049) as risk factors for recurrent SCVs. In multivariate analysis, prior TMP-SMX use was the sole independent risk factor for recurrent SCVs (OR: 2.280,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028). A significant decline in respiratory function over time (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025) was observed in patients with recurrent SCVs, but not in those with a single SCV episode. Resistance to TMP-SMX was observed in nearly all isolates tested (231\/234) with available antibiotic susceptibility testing results. SCV detection frequency decreased over the study period (19.06% in 2017 vs. 5.83% in 2023,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.00001), probably due to the increased use of elexacaftor-tezaxaftor-ivacaftor.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      <jats:italic>S. aureus<\/jats:italic>\n                      SCVs were highly prevalent in pwCF, although their frequency declined over time with the widespread use of elexacaftor\u2013tezacaftor\u2013ivacaftor. Recurrent SCV detections, but not single episodes, were associated with a progressive decline in respiratory function. Prior TMP-SMX exposure was identified as an independent risk factor for recurrent SCV detections. The clinical implications of these findings require further investigation to clarify causality and guide management strategies.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10096-025-05313-3","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:40:15Z","timestamp":1761824415000},"page":"441-449","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and risk factors for recurrent Staphylococcus aureus small-colony variants in people with cystic fibrosis followed at the Tuscan Regional Reference Center"],"prefix":"10.1007","volume":"45","author":[{"given":"Vito","family":"Terlizzi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Fevola","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Dolce","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Campana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelica","family":"Terri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Taccetti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Chiappini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"5313_CR1","doi-asserted-by":"crossref","unstructured":"Grasemann H, Ratjen F, Cystic DB (eds) (2023) N Engl J M(ed). ;389:1693\u2013707","DOI":"10.1056\/NEJMra2216474"},{"key":"5313_CR2","doi-asserted-by":"publisher","DOI":"10.1177\/17534666251323194","volume":"19","author":"V Terlizzi","year":"2025","unstructured":"Terlizzi V, Lopes-Pacheco M (2025) Cystic fibrosis: new challenges and perspectives beyond elexacaftor\/tezacaftor\/ivacaftor. 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