{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:34:02Z","timestamp":1787510042777,"version":"build-2736575974"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007641","name":"MDL","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007641","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The skin-to-blood route is traditionally considered the main pathway in Candida late-onset sepsis (LOS) development in preterm infants. However, emerging evidence suggests that the gut also serves as a source of infection. We aimed to characterize fecal mycobiota and microbiota profiles preceding onset of Candida LOS to assess the role of the preterm gut microbiome in disease development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter case-control study included very preterm infants (&amp;lt;30 weeks of gestation) with Candida LOS. Each case was matched to nonaffected controls by gestational and postnatal age, hospital site, and\/or cumulative antibiotic exposure prior to day of LOS onset (t = 0). Fecal samples collected at t = 0 and the 5 preceding days were analyzed by ITS1 and 16S RNA sequencing. Microbial amplicon yields, composition, and interkingdom correlations were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 2397 screened infants, fecal samples were available for 8 of 19 infants with Candida LOS. In these 8 cases, the ITS\/16S amplicon yield ratio was increased (P &amp;lt; .001), and the relative abundance of fecal Candida albicans correlated positively with fungal amplicon yield (\u03c1 = 0.71, adjusted P = .005), suggesting increased absolute abundance up to 5 days before onset. Additionally, bacterial yields were significantly lower (P = .02) and \u03b1-diversity significantly decreased (P = .012) when compared to the controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Increased fecal C albicans preceded Candida LOS onset, implicating the preterm gut as a potential source of infection. Reduced bacterial yields and diversity suggest ecological alterations that may facilitate Candida pathogenicity in the preterm gut. These findings support further research into gut-derived Candida LOS and the potential for microbiota-targeted prevention strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf524","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T12:14:23Z","timestamp":1760012063000},"page":"e570-e581","source":"Crossref","is-referenced-by-count":2,"title":["The Gut as a Source of Infection for Fungal Pathogens: Increased Fecal\n                    <i>Candida albicans<\/i>\n                    Precedes Onset of\n                    <i>Candida<\/i>\n                    Late-Onset Sepsis in Very Preterm Infants"],"prefix":"10.1093","volume":"233","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7971-3120","authenticated-orcid":false,"given":"Rimke R","family":"de Kroon","sequence":"first","affiliation":[{"name":"Amsterdam Reproduction and Development Research Institute , Amsterdam UMC, Amsterdam, the Netherlands"},{"name":"Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam UMC, Amsterdam, the \u00a0","place":["Netherlands"]},{"name":"Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, Amsterdam, the \u00a0","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6640-8055","authenticated-orcid":false,"given":"Irini A M","family":"Kreulen","sequence":"additional","affiliation":[{"name":"Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam UMC, Amsterdam, the \u00a0","place":["Netherlands"]},{"name":"Tytgat Institute for Liver and Intestinal Research, Amsterdam UMC, University of Amsterdam, Amsterdam, the \u00a0","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3081-9124","authenticated-orcid":false,"given":"Mark","family":"Davids","sequence":"additional","affiliation":[{"name":"Microbiota Center 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