{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T16:00:11Z","timestamp":1768406411003,"version":"3.49.0"},"reference-count":27,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Maternal and Child Health IRCCS Burlo Garofolo, Trieste\u2014Italy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>A preterm neonate born at 24 + 5 weeks gestation developed congenital Candida krusei sepsis, diagnosed via placental culture, axillary swab, and elevated beta-glucan levels. Although initial blood cultures were negative, continuous HeRo monitoring played a crucial role in the early detection of clinical deterioration, prompting timely antifungal therapy with amphotericin B followed by micafungin. This proactive approach, combining prompt diagnosis, HeRo surveillance, and tailored treatment, ensured a favorable outcome. Our case underscores the value of HeRo monitoring as an early warning tool in managing neonatal fungal infections.<\/jats:p>","DOI":"10.3390\/antibiotics14070666","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T07:42:06Z","timestamp":1751355726000},"page":"666","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Congenital Candida krusei Sepsis in an Extremely Preterm Baby: Case Report and Literature Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0382-3825","authenticated-orcid":false,"given":"Francesca","family":"Cossovel","sequence":"first","affiliation":[{"name":"Department of Neonatology, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34137 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Nider","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34137 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2599-0701","authenticated-orcid":false,"given":"Jenny","family":"Bua","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34137 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Ghirigato","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Health Sciences, University of Trieste, 34127 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Piccoli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34137 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1340-3493","authenticated-orcid":false,"given":"Paolo","family":"Manzoni","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Neonatology, University Hospital Degli Infermi, 13875 Biella, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Travan","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34137 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"24","DOI":"10.3109\/14767058.2011.604929","article-title":"The management of Candida infections in preterm neonates and the role of micafungin","volume":"24","author":"Manzoni","year":"2011","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/civ933","article-title":"Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America","volume":"62","author":"Pappas","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S445","DOI":"10.1093\/infdis\/jix131","article-title":"Multidrug-Resistant Candida: Epidemiology, molecular mechanisms, and treatment","volume":"216","author":"Arendrup","year":"2017","journal-title":"J. Infect. Dis."},{"key":"ref_4","first-page":"e00536-20","article-title":"Comparison of EUCAST and CLSI reference microdilution MICs of fluconazole and voriconazole for Candida species and the definition of epidemiological cutoff values","volume":"64","author":"Arendrup","year":"2020","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Baltogianni, M., Giapros, V., and Dermitzaki, N. (2024). Recent Challenges in Diagnosis and Treatment of Invasive Candidiasis in Neonates. Children, 11.","DOI":"10.20944\/preprints202408.1064.v1"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s40506-022-00258-z","article-title":"Updates in the Pharmacologic Prophylaxis and Treatment of Invasive Candidiasis in the Pediatric and Neonatal Intensive Care Units: Updates in the Pharmacologic Prophylaxis","volume":"14","author":"Fly","year":"2022","journal-title":"Curr. Treat. Options Infect. Dis."},{"key":"ref_7","first-page":"45","article-title":"Congenital Candidemia Due to Candida krusei: A Case Report","volume":"1","author":"Wanjari","year":"2008","journal-title":"J. Neonatal-Perinat. Med."},{"key":"ref_8","first-page":"560","article-title":"Early-Onset Neonatal Candidiasis: A Case Series of Three Preterm Infants","volume":"31","author":"Martins","year":"2012","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"177","DOI":"10.3109\/13693780902824962","article-title":"Congenital candidiasis: Confirmation of mother-neonate transmission using molecular analysis techniques","volume":"48","author":"Tiraboschi","year":"2010","journal-title":"Med. Mycol."},{"key":"ref_10","unstructured":"Gauteng Neonatal Consortium (2014). Nosocomial Outbreak of Candida krusei Candidemia in a South African NICU: Risk Factors and Outcomes. J. Hosp. Infect., 86, 178\u2013184."},{"key":"ref_11","unstructured":"National Neonatology Forum of India (2019). Invasive Candidiasis in Very Low Birth Weight Infants: A Multicenter Cohort Study. Indian Pediatr., 56, 743\u2013748."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"100659","DOI":"10.1016\/j.mmcr.2024.100659","article-title":"Rare Case of Early Neonatal Sepsis Caused by Candida krusei Successfully Treated With Voriconazole","volume":"45","author":"Shashi","year":"2024","journal-title":"Med. Mycol. Case Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1056\/NEJM200005183422007","article-title":"Intrauterine Infection and Preterm Delivery","volume":"342","author":"Goldenberg","year":"2000","journal-title":"N. Engl. J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.clp.2024.10.004","article-title":"Neonatal Invasive Fungal Infections: Epidemiology, Microbiology, and Controversies in Practice","volume":"52","author":"Kaufman","year":"2025","journal-title":"Clin. Perinatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1016\/j.clp.2010.06.003","article-title":"Strategies to prevent invasive candidal infection in extremely preterm infants","volume":"37","author":"Kaufman","year":"2010","journal-title":"Clin. Perinatol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"De Rose, D.U., Piersigilli, F., Goffredo, B.M., Danhaive, O., Dotta, A., and Auriti, C. (2021). Treatment with micafungin in a preterm neonate with invasive Candida parapsilosis infection. Pathogens, 10.","DOI":"10.3390\/pathogens10070890"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1097\/MOP.0b013e32835e8fe6","article-title":"Predictive monitoring for early detection of sepsis in neonatal ICU patients","volume":"25","author":"Fairchild","year":"2013","journal-title":"Curr. Opin. Pediatr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e865","DOI":"10.1542\/peds.2009-3412","article-title":"Neonatal candidiasis: Epidemiology, risk factors, and clinical judgment","volume":"126","author":"Benjamin","year":"2010","journal-title":"Pediatrics"},{"key":"ref_19","first-page":"880","article-title":"Current Performance of the (1\u21923)-\u03b2-D-Glucan Assay in the Diagnosis of Invasive Fungal Infections","volume":"27","author":"Taira","year":"2021","journal-title":"J. Infect. Chemother."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"myac032","DOI":"10.1093\/mmy\/myac032","article-title":"Serial (1-3)-beta-D-Glucan (BDG) monitoring shows high variability among premature neonates","volume":"60","author":"Aziz","year":"2022","journal-title":"Med. Mycol."},{"key":"ref_21","first-page":"683","article-title":"Role of Biomarkers in Invasive Candidiasis: Past, Present, and Future","volume":"59","author":"Morrell","year":"2021","journal-title":"Med. Mycol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Zuccari, G., Villa, C., Iurilli, V., Barabino, P., Zorzoli, A., Marimpietri, D., Caviglia, D., and Russo, E. (2024). AmBisome\u00ae Formulations for Pediatrics: Stability, Cytotoxicity, and Cost-Effectiveness Studies. Pharmaceutics, 16.","DOI":"10.3390\/pharmaceutics16040466"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"i73","DOI":"10.1093\/jac\/dkx451","article-title":"Biofilms and beyond: Expanding echinocandin utility","volume":"73","author":"Larkin","year":"2018","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e02494-20","DOI":"10.1128\/AAC.02494-20","article-title":"High-dose micafungin in neonates and young infants with invasive candidiasis: Results of a phase 2 study","volume":"65","author":"Auriti","year":"2021","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_25","unstructured":"European Medicines Agency (2025, January 30). Micafungin Summary of Product Characteristics. EMA, Available online: https:\/\/www.ema.europa.eu\/en\/documents\/product-information\/mycamine-epar-product-information_en.pdf."},{"key":"ref_26","first-page":"109","article-title":"Early Diagnosis and Treatment Reduce Mortality in Neonatal Candidemia","volume":"40","author":"Pappas","year":"2021","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1345\/aph.1Q346","article-title":"Echinocandin use in the neonatal intensive care unit","volume":"46","author":"Caudle","year":"2012","journal-title":"Ann. 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