{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T06:39:22Z","timestamp":1769582362196,"version":"3.49.0"},"reference-count":54,"publisher":"American Society for Microbiology","issue":"3","license":[{"start":{"date-parts":[[2016,3,1]],"date-time":"2016-03-01T00:00:00Z","timestamp":1456790400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","award":["IX-DK-131-0286"],"award-info":[{"award-number":["IX-DK-131-0286"]}],"id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001704","name":"European Society of Clinical Microbiology and Infectious Diseases","doi-asserted-by":"publisher","award":["Research Grant 2013"],"award-info":[{"award-number":["Research Grant 2013"]}],"id":[{"id":"10.13039\/501100001704","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            The prevalence of intrinsic and acquired resistance among colonizing\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Candida<\/jats:named-content>\n            isolates from patients after candidemia was investigated systematically in a 1-year nationwide study. Patients were treated at the discretion of the treating physician. Oral swabs were obtained after treatment. Species distributions and MIC data were investigated for blood and posttreatment oral isolates from patients exposed to either azoles or echinocandins for &lt;7 or \u22657 days. Species identification was confirmed using matrix-assisted laser desorption ionization\u2013time of flight mass spectrometry (MALDI-TOF MS) and internal transcribed spacer (ITS) sequencing, susceptibility was examined by EUCAST EDef 7.2 methodology, echinocandin resistance was examined by\n            <jats:italic>FKS<\/jats:italic>\n            sequencing, and genetic relatedness was examined by multilocus sequence typing (MLST). One hundred ninety-three episodes provided 205 blood and 220 oral isolates. MLST analysis demonstrated a genetic relationship for 90% of all paired blood and oral isolates. Patients exposed to azoles for \u22657 days (\n            <jats:italic>n<\/jats:italic>\n            = 93) had a significantly larger proportion of species intrinsically less susceptible to azoles (particularly\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Candida glabrata<\/jats:named-content>\n            ) among oral isolates than among initial blood isolates (36.6% versus 12.9%;\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.001). A similar shift toward species less susceptible to echinocandins among 85 patients exposed to echinocandins for \u22657 days was not observed (4.8% of oral isolates versus 3.2% of blood isolates;\n            <jats:italic>P<\/jats:italic>\n            &gt; 0.5). Acquired resistance in\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Candida albicans<\/jats:named-content>\n            was rare (&lt;5%). However, acquired resistance to fluconazole (29.4%;\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.05) and anidulafungin (21.6%;\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.05) was common in\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">C. glabrata<\/jats:named-content>\n            isolates from patients exposed to either azoles or echinocandins. Our findings suggest that the colonizing mucosal microbiota may be an unrecognized reservoir of resistant\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Candida<\/jats:named-content>\n            species, especially\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">C. glabrata<\/jats:named-content>\n            , following treatment for candidemia. The resistance rates were high, raising concern in general for patients exposed to antifungal drugs.\n          <\/jats:p>","DOI":"10.1128\/aac.01763-15","type":"journal-article","created":{"date-parts":[[2015,12,29]],"date-time":"2015-12-29T03:23:15Z","timestamp":1451359395000},"page":"1500-1508","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":68,"title":["Posttreatment Antifungal Resistance among Colonizing Candida Isolates in Candidemia Patients: Results from a Systematic Multicenter Study"],"prefix":"10.1128","volume":"60","author":[{"given":"R. H.","family":"Jensen","sequence":"first","affiliation":[{"name":"Unit of Mycology, Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. K.","family":"Johansen","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. M.","family":"S\u00f8es","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Hvidovre University Hospital, Hvidovre, Denmark"},{"name":"Department of Clinical Microbiology, Slagelse Sygehus, Slagelse, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. E.","family":"Lemming","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. S.","family":"Rosenvinge","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Sygehus Lilleb\u00e6lt, Vejle, Denmark"},{"name":"Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Herlev University Hospital, Herlev, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Olesen","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Nordsj\u00e6llands Hospital, Hiller\u00f8d, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Kristensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Hospitalsenheden Vest, Herning, Denmark"},{"name":"Department of Clinical Microbiology, Hospitalsenheden Midt, Viborg, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Dzajic","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Sydvestjysk Sygehus, Esbjerg, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. 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