{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T17:37:06Z","timestamp":1792863426933,"version":"4.5.0"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T00:00:00Z","timestamp":1678147200000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000737","name":"University of Exeter","doi-asserted-by":"publisher","award":["MR\/N006364\/2"],"award-info":[{"award-number":["MR\/N006364\/2"]}],"id":[{"id":"10.13039\/501100000737","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000737","name":"University of Exeter","doi-asserted-by":"publisher","award":["MR\/V033417\/1"],"award-info":[{"award-number":["MR\/V033417\/1"]}],"id":[{"id":"10.13039\/501100000737","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Neonatal invasive candidiasis (NIC) has significant morbidity and mortality. Reports have shown a different profile of those neonates affected with NIC and of fluconazole-resistant Candida spp. isolates in low- and middle-income countries (LMICs) compared to high-income countries (HICs). We describe the epidemiology, Candida spp. distribution, treatment, and outcomes of neonates with NIC from LMICs enrolled in a global, prospective, longitudinal, observational cohort study (NeoOBS) of hospitalized infants &amp;lt;60 days postnatal age with sepsis (August 2018\u2013February 2021). A total of 127 neonates from 14 hospitals in 8 countries with Candida spp. isolated from blood culture were included. Median gestational age of affected neonates was 30 weeks (IQR: 28\u201334), and median birth weight was 1270\u00a0gr (interquartile range [IQR]: 990\u20131692). Only a minority had high-risk criteria, such as being born &amp;lt;28 weeks, 19% (24\/127), or birth weight &amp;lt;1000\u00a0gr, 27% (34\/127). The most common Candida species were C. albicans (n\u00a0=\u00a045, 35%), C. parapsilosis (n\u00a0=\u00a038, 30%), and Candida auris (n\u00a0=\u00a018, 14%). The majority of C. albicans isolates were fluconazole susceptible, whereas 59% of C. parapsilosis isolates were fluconazole-resistant. Amphotericin B was the most common antifungal used [74% (78\/105)], followed by fluconazole [22% (23\/105)]. Death by day 28 post-enrollment was 22% (28\/127). To our knowledge, this is the largest multi-country cohort of NIC in LMICs. Most of the neonates would not have been considered at high risk for NIC in HICs. A substantial proportion of isolates was resistant to first choice fluconazole. Understanding the burden of NIC in LMIC is essential to guide future research and treatment guidelines.<\/jats:p>","DOI":"10.1093\/mmy\/myad010","type":"journal-article","created":{"date-parts":[[2023,3,4]],"date-time":"2023-03-04T01:25:59Z","timestamp":1677893159000},"source":"Crossref","is-referenced-by-count":64,"title":["Neonatal invasive candidiasis in low- and middle-income countries: Data from the NeoOBS study"],"prefix":"10.1093","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9189-7815","authenticated-orcid":false,"given":"Aislinn","family":"Cook","sequence":"first","affiliation":[{"name":"Centre for Neonatal and Paediatric Infection, St. George's University of London , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2871-1747","authenticated-orcid":false,"given":"Laura","family":"Ferreras-Antolin","sequence":"additional","affiliation":[{"name":"Centre for Neonatal and Paediatric Infection, St. George's University of London , London , UK"},{"name":"MRC Centre for Medical Mycology, University of Exeter , Exeter , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethou","family":"Adhisivam","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER) , Pondicherry , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daynia","family":"Ballot","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand , Johannesburg , South Africa"},{"name":"Charlotte Maxeke Johannesburg Academic Hospital , Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A","family":"Berkley","sequence":"additional","affiliation":[{"name":"Clinical Research Department , KEMRI-Wellcome Trust Research Programme, Kilifi , Kenya"},{"name":"Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford , Oxford , UK"},{"name":"The Childhood Acute Illness & Nutrition (CHAIN) Network , Nairobi , Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Bernaschi","sequence":"additional","affiliation":[{"name":"Microbiology Unit, Bambino Ges\u00f9 Children's Hospital , Rome , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina G","family":"Carvalheiro","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Ribeir\u00e3o Preto Medical School, University , S\u00e3o Paulo, Brazil"},{"name":"of S\u00e3o Paulo , S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Napaporn","family":"Chaikittisuk","sequence":"additional","affiliation":[{"name":"Queen Sirikit National Institute of Child Health , Bangkok , 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M","family":"Mussi-Pinhata","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Ribeir\u00e3o Preto Medical School, University , S\u00e3o Paulo, Brazil"},{"name":"of S\u00e3o Paulo , S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Namiiro","sequence":"additional","affiliation":[{"name":"Mulago Specialised Women and Neonatal Hospital , Kampala , Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gita","family":"Natraj","sequence":"additional","affiliation":[{"name":"Seth G. 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