{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:23:15Z","timestamp":1786980195221,"version":"build-2736575974"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100008359","name":"Maag Lever Darm Stichting","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Invasive candidiasis poses a serious risk to preterm infants, due to its rapidly progressive and severe clinical course, resulting in considerable mortality and long-term morbidity. Therefore, the aim of the current study was to assess the clinical characteristics of invasive candidiasis in very preterm infants to increase awareness among clinicians. A multicenter cohort study database was screened for infants, born in one of ten Neonatal Intensive Care Units (NICUs) in the Netherlands and Belgium between October 2014 and May 2025, with blood- and\/or cerebrospinal fluid culture-proven invasive candidiasis (gestational age\u2009&lt;\u200930\u00a0weeks) in the first 29\u00a0days of life. Clinical data were retrospectively collected. Out of 2.824 infants, 24 were diagnosed with invasive candidiasis (0.8%), most frequently caused by\n                    <jats:italic>Candida albicans<\/jats:italic>\n                    (83%). Affected infants demonstrated distinct clinical features: extreme prematurity (mean 25.7\u00a0weeks\u2009\u00b1\u20099\u00a0days), low birth weight (mean 827\u2009\u00b1\u2009198\u00a0g), vaginal delivery (88%), and sepsis and\/or gastrointestinal disease prior to clinical onset (46%). In 58%, initiation of antifungal treatment was delayed. The disease course was generally severe with end-organ disseminated candidiasis (33%), need for invasive ventilation (58%), cardiorespiratory support (42%), and red blood cell and\/or platelet transfusion (71% and 33%). Both C-reactive protein and platelet count at diagnosis were associated with fatal outcome (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.040 and\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.010, respectively).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusion<\/jats:italic>\n                    : In infants with distinct clinical features, clinicians should maintain a high index of suspicion, particularly in NICUs with a higher incidence of\n                    <jats:italic>Candida<\/jats:italic>\n                    colonization and\/or infection. Our findings underline the need for a rapid diagnostic test to reduce treatment delays and improve clinical outcomes.\n                    <jats:table-wrap>\n                      <jats:table>\n                        <jats:tbody>\n                          <jats:tr>\n                            <jats:td align=\"left\">\n                              <jats:bold>What is known:<\/jats:bold>\n                              \u2022\n                              <jats:italic>Invasive candidiasis poses a risk to preterm infants due to its rapidly progressive disease course, high mortality, and long-term morbidity.<\/jats:italic>\n                              \u2022\n                              <jats:italic>A critical need exists to enhance vigilance among clinicians, enabling timely diagnosis,\u00a0and initiation of targeted treatment.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                          <jats:tr>\n                            <jats:td align=\"left\">\n                              <jats:bold>What is new:<\/jats:bold>\n                              \u2022\n                              <jats:italic>Affected infants are characterized by shared clinical features and substantial disease burden.<\/jats:italic>\n                              \u2022\n                              <jats:italic>Frequent vaginal delivery in affected infants suggests that colonization and infection may result from vertical transmission, offering opportunities for early prevention.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                        <\/jats:tbody>\n                      <\/jats:table>\n                    <\/jats:table-wrap>\n                  <\/jats:p>","DOI":"10.1007\/s00431-025-06694-5","type":"journal-article","created":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T18:42:45Z","timestamp":1768070565000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical characteristics of invasive candidiasis in infants born before 30\u00a0weeks of gestation: a nested case series from a multicenter cohort study in the Netherlands and Belgium"],"prefix":"10.1007","volume":"185","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7971-3120","authenticated-orcid":false,"given":"Rimke R.","family":"de Kroon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6957-3850","authenticated-orcid":false,"given":"Aranka J.","family":"van Wesemael","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8086-9552","authenticated-orcid":false,"given":"Mirjam M.","family":"van Weissenbruch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7556-5896","authenticated-orcid":false,"given":"Tim","family":"de Meij","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0844-7208","authenticated-orcid":false,"given":"Hendrik J.","family":"Niemarkt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the generation P studygroup","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris H. P.","family":"van den Akker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina M.","family":"Frerichs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlou M. A.","family":"Kouwenberg-Raets","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian V.","family":"Hulzebos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"d\u2019Haens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willem P.","family":"de Boode","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Roze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel C.","family":"Vijlbrief","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veerle","family":"Cossey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,10]]},"reference":[{"issue":"4","key":"6694_CR1","doi-asserted-by":"publisher","first-page":"e865","DOI":"10.1542\/peds.2009-3412","volume":"126","author":"DK Benjamin Jr","year":"2010","unstructured":"Benjamin DK Jr, Stoll BJ, Gantz MG, Walsh MC, S\u00e1nchez PJ, Das A et al (2010) Neonatal candidiasis: epidemiology, risk factors, and clinical judgment. 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The study was approved by the Medisch Ethische Toetsingscommissie (METC), the Dutch equivalent of the Institutional Review Broad, of the VU medical center (protocol 2014.386, amendment A2016.363). Written informed consent was obtained from parent(s) or legal guardian(s) for all infants.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"70"}}