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Given this context, the study investigated\n                    <jats:italic>Candida<\/jats:italic>\n                    isolates from neonatal infections in a Brazilian tertiary hospital, focusing on clinical and epidemiological aspects, antifungal susceptibility, and virulence factors. This retrospective observational study was conducted from 2018 to 2024 in a Brazilian NICU. Clinical and demographic data were obtained from medical records of 40 neonates with culture-confirmed\n                    <jats:italic>Candida<\/jats:italic>\n                    infections. Antifungal susceptibility testing followed Clinical and Laboratory Standards Institute (CLSI) guidelines. Hemolysin, phospholipase, and biofilm production were evaluated phenotypically. A total of 57\n                    <jats:italic>Candida<\/jats:italic>\n                    isolates were recovered from 40 neonates. The most frequently identified species were\n                    <jats:italic>C. parapsilosis<\/jats:italic>\n                    (33.3%),\n                    <jats:italic>C. albicans<\/jats:italic>\n                    (22.8%), and\n                    <jats:italic>C. tropicalis<\/jats:italic>\n                    (12.3%). Persistent candidemia was observed in 10\/40 (25.0%) cases. The overall mortality rate was 45.0%. Notably, four of the fatal cases were associated with strong biofilm-producing strains, and one of these isolates\u2014\n                    <jats:italic>C. lusitaniae<\/jats:italic>\n                    \u2014also exhibited high phospholipase activity. Fluconazole and micafungin were the most commonly used antifungal agents. All tested isolates were susceptible to micafungin, while fluconazole showed variable minimum inhibitory concentrations (MICs). Hemolysin and phospholipase activity were detected in most isolates, and approximately 66% were classified as strong biofilm producers. Non-\n                    <jats:italic>albicans Candida<\/jats:italic>\n                    species represented the majority of isolates and showed marked virulence attributes and variable antifungal susceptibility. These findings highlight the importance of local surveillance, species-level identification, virulence profiling, and antifungal susceptibility testing to improve clinical outcomes and manage resistance in NICUs.\n                  <\/jats:p>","DOI":"10.1007\/s42770-026-01933-9","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T13:57:52Z","timestamp":1779803872000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Neonatal Candida infections in Brazil: study on virulence and antifungal susceptibility with predominance of non-albicans Candida"],"prefix":"10.1007","volume":"57","author":[{"given":"Natalia Daiane Garoni","family":"Martins","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fab\u00edola","family":"Lucini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca Canupa Mancuzo","family":"Nascimento","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T\u00falio M\u00e1ximo","family":"Salom\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie Gaebler","family":"Vasconcelos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Let\u00edcia Cristina","family":"Limiere","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvane Cavalheiro","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6115-3313","authenticated-orcid":false,"given":"Luana","family":"Rossato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"1933_CR1","doi-asserted-by":"publisher","first-page":"35","DOI":"10.5123\/S2176-62232015000400005","volume":"6","author":"AG Chermont","year":"2015","unstructured":"Chermont AG, Rodrigues RA-A, Praxedes FB, Monma CA, Pinheiro RET, Nascimento (2015) L.C.C. do Candidemia Em Unidade Materno Infantil de Refer\u00eancia: Aspectos Cl\u00ednico-Epidemiol\u00f3gicos e Fatores de Risco Em Prematuros Com Peso Inferior a 1.500\u00a0g. 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