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This prospective cohort study examined oral fungal carriage in HSCT recipients and screened the susceptibility against commonly used antifungal agents. An increasing oral occurrence of C\n                      <jats:italic>andida<\/jats:italic>\n                      spp. and the development of resistance against clinically administered fluconazole were hypothesized.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two hundred HSCT recipients were included and followed up for 2\u00a0years post-HSCT. Oral microbiological specimens were analyzed with matrix-assisted laser desorption\/ionization-time of flight mass spectrometry assays (MALDI-TOF). The colorimetric method was applied for the susceptibility testing by commercially available Sensititre YeastOne (SYO\u00ae, TREK Diagnostics Systems, Thermo-Fisher, UK).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalence of oral\n                      <jats:italic>Candida<\/jats:italic>\n                      spp. carriage increased statistically significantly after a year post-HSCT being 30, 26, 35, 44, and 47%, pre-HSCT, 3, 6, 12, and 24\u00a0months post-HSCT, respectively. Altogether, 169 clinical oral\n                      <jats:italic>Candida<\/jats:italic>\n                      strains were isolated. Fourteen\n                      <jats:italic>Candida<\/jats:italic>\n                      spp. were identified, and\n                      <jats:italic>C. albicans<\/jats:italic>\n                      was predominant in 74% of the isolates pre-HSCT with a descending prevalence down to 44% 2\u00a0years post-HSCT. An increasing relative proportion of non\n                      <jats:italic>-albicans<\/jats:italic>\n                      species post-HSCT was evident. No development of resistance of\n                      <jats:italic>C. albicans<\/jats:italic>\n                      against fluconazole was found. Instead, a shift from\n                      <jats:italic>C. albicans<\/jats:italic>\n                      towards non-\n                      <jats:italic>albicans<\/jats:italic>\n                      species, especially\n                      <jats:italic>C. dubliensis<\/jats:italic>\n                      ,\n                      <jats:italic>C. glabrata<\/jats:italic>\n                      , and relatively seldom found\n                      <jats:italic>C. krusei<\/jats:italic>\n                      , was observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Oral\n                      <jats:italic>Candida<\/jats:italic>\n                      carriage increases after HSCT. Instead of the expected development of resistance of\n                      <jats:italic>C. albicans<\/jats:italic>\n                      against fluconazole, the relative proportion of non\n                      <jats:italic>-albicans<\/jats:italic>\n                      strains with innate resistance against azole-group antifungals increased.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00520-024-08396-4","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T11:03:35Z","timestamp":1708686215000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Oral Candida carriage and resistance against common antifungal agents in hematopoietic stem cell transplantation recipients"],"prefix":"10.1007","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0107-4939","authenticated-orcid":false,"given":"Matti","family":"Mauramo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nurg\u00fcl","family":"Tonoz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rg","family":"Halter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Betsy","family":"Joseph","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tuomas","family":"Waltimo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,2,23]]},"reference":[{"key":"8396_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/0003-9969(80)90147-8","volume":"25","author":"TM Arendorf","year":"1980","unstructured":"Arendorf TM, Walker DM (1980) The prevalence and intra-oral distribution of Candida albicans in man. 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A written informed consent was obtained from each subject.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interest"}}],"article-number":"185"}}