Seminars In Perinatology[JOURNAL]
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200 papers
Congenital cytomegalovirus: Screening strategies and diagnostic challenges.
Ravin K, Stillwell T
Semin Perinatol · 2026 Jul · PMID 42386471 · Publisher ↗
Congenital cytomegalovirus (cCMV) infection is the most common congenital infection worldwide and a leading cause of sensorineural hearing loss (SNHL). Most newborns with cCMV will be asymptomatic at birth; however, a su...
Congenital cytomegalovirus (cCMV) infection is the most common congenital infection worldwide and a leading cause of sensorineural hearing loss (SNHL). Most newborns with cCMV will be asymptomatic at birth; however, a subset will go on to develop disease, including SNHL and neurodevelopmental problems, later in life. Given this, advocacy for newborn cCMV screening is growing. Targeted versus universal screening remains a hotly debated topic. This review will assess current diagnostic and screening modalities and explore unanswered questions.
The society for neonatal nutrition and lifelong health: Building science and translating research to inform neonatal nutritional care.
Taylor SN, Martin CR
Semin Perinatol · 2026 Jun · PMID 42364968 · Publisher ↗
Abstract loading — click title to view on PubMed.
Enteral nutrition to optimize health and neurodevelopmental outcomes in very preterm infants.
Santoro KL, Valentine G, Hair AB
Semin Perinatol · 2026 Jun · PMID 42362409 · Publisher ↗
BACKGROUND: Very preterm infants are born before a critical window of nutrient accrual that occurs during the third trimester, resulting in a nutritional deficit that is vital to restore to support further growth and dev...
BACKGROUND: Very preterm infants are born before a critical window of nutrient accrual that occurs during the third trimester, resulting in a nutritional deficit that is vital to restore to support further growth and development. Although the gut is underdeveloped, optimizing administration of nutrition via the enteral route has been linked to improved long term outcomes, particularly when mother's own milk is prioritized as the initial source of nutrition. OBJECTIVE: The goal of this review was to synthesize current evidence on best enteral nutrition practices for very preterm infants focusing on strategies that optimize long term neurodevelopment and infant health outcomes. CONTENT: This review examines the physiological importance of early enteral nutrition to support growth and neurodevelopment of very preterm infants. Clinical outcomes data related to different types of enteral nutrition sources are reviewed, as well as evidence-based practices regarding initiation of enteral nutrition, advancement, supplementation and fortification. Additionally, limitations in the existing literature are identified to inform future research directions. CONCLUSIONS: The collective evidence reviewed in this manuscript supports early, consistent, and human milk-based enteral nutrition as a central modifiable factor to improve growth, brain development, and long-term neurodevelopmental outcomes. While there are remaining uncertainties regarding the ideal timing for initiation, specific advancement strategies, and fortification methods, the available data supports the following: minimizing enteral fasting, prioritizing mother's own milk, and using protocolized feeding guidelines.
Standardizing outcome measures in preterm infant nutrition research: Use of anthropometry and body composition in the neonatal intensive care unit.
Bell KA, Calkins KL, Gollins LA … +2 more , McNelis K, Strobel KM
Semin Perinatol · 2026 Jun · PMID 42342487 · Publisher ↗
Nutritional care and growth patterns in the neonatal intensive care unit (NICU) can impact lifelong health. Standardized measurement and reporting of growth outcomes are critical to improve the quality of information gen...
Nutritional care and growth patterns in the neonatal intensive care unit (NICU) can impact lifelong health. Standardized measurement and reporting of growth outcomes are critical to improve the quality of information generated in research and population surveillance, facilitate comparisons and meta-analyses across individual studies, and strengthen the evidence used to generate clinical practice recommendations. Anthropometrics, specifically weight, length, and head circumference, are feasible and practical methods to monitor nutritional status. For research purposes, we recommend these anthropometrics be measured at birth (as a measure of fetal growth), 28 days old (to assess short-term growth), and 36 weeks postmenstrual age (PMA) (to determine the postnatal growth pattern in the NICU). We also encourage recording number of days to regain birthweight as a measure of short-term growth. Research publications should describe clearly the methods used to measure anthropometrics and reference curves used to calculate z-scores. Body composition is a complementary marker of nutritional status, but currently validated techniques have practical limitations in the NICU. When body composition tools are available, fat-free mass and fat mass should be measured at ∼36 weeks PMA. We also describe key knowledge gaps and research priorities regarding growth patterns of preterm infants in the NICU.
A dilemma of parental inclusion? Parent perspectives of NICU feeding practices and neonatal nutritional research.
Perez KM, Jochim A, Patel AL … +1 more , Valentine GC
Semin Perinatol · 2026 Jun · PMID 42342486 · Publisher ↗
Feeding premature infants in the NICU is a ubiquitous need, one where mother's own milk (MOM) has been shown to have nutritional and therapeutic benefits lasting well into childhood. Beyond the need for and importance of...
Feeding premature infants in the NICU is a ubiquitous need, one where mother's own milk (MOM) has been shown to have nutritional and therapeutic benefits lasting well into childhood. Beyond the need for and importance of enteral MOM feeding, there is a paucity of high-level evidence to inform what, when and how to feed premature infants. Thus, variation in nutritional practices is common within and between NICUs, and parents of premature infants commonly experience distress with the removal of typically parent-led feeding decisions. Furthermore, NICU parent voices remain poorly represented in the literature and feeding outcomes measured are often limited to growth metrics, which fail to capture parent priorities and meaningful outcomes the life course of the parent and child. In this review, we discuss the parent perspectives of NICU nutritional feeding practices, highlighting the gaps in the literature and opportunities to improve the long-term wellness of the dyad when feeding guidelines consider parents' perspectives.
Maternal diet and nutritional status during pregnancy and lactation: a review of implications on milk composition and lactation outcomes.
Ayande R, Sen S, Robinson DT
Semin Perinatol · 2026 Jun · PMID 42323262 · Publisher ↗
Maternal diet and nutritional status during lactation have important implications for human milk composition and lactation outcomes, yet the strength and consistency of these associations remain incompletely understood....
Maternal diet and nutritional status during lactation have important implications for human milk composition and lactation outcomes, yet the strength and consistency of these associations remain incompletely understood. This narrative review synthesizes current evidence on (1) the role of maternal dietary intake on human milk macronutrients, fatty acids, human milk oligosaccharides (HMOs), and other bioactive compounds; (2) the influence of maternal nutritional status, including body mass index (BMI), gestational weight gain, gestational diabetes, food insecurity, and biochemical nutrient markers, on milk composition; and (3) the relationship between maternal diet and nutritional status and lactation outcomes, including initiation, duration, and milk production. Methodological heterogeneity in dietary assessment, milk sampling protocols, and definitions of nutritional status limits comparability across studies. Standardized approaches and mechanistic research are needed to clarify causal pathways and identify modifiable targets to optimize milk composition and support successful lactation.
Initial nutrition in preterm infants: Evidence, uncertainty, and research priorities.
Holzapfel LF, Thoene MK, Robinson DT … +1 more , Valentine GC
Semin Perinatol · 2026 Jun · PMID 42323261 · Publisher ↗
Initial nutrition during the fetal-to-neonatal transition is critical for preterm infants and requires balancing physiologic adaptation, metabolic tolerance, and risk of morbidity. Although traditional approaches favored...
Initial nutrition during the fetal-to-neonatal transition is critical for preterm infants and requires balancing physiologic adaptation, metabolic tolerance, and risk of morbidity. Although traditional approaches favored delayed enteral feeding with prolonged parenteral nutrition to protect the immature gastrointestinal tract, accumulating evidence supports earlier initiation of enteral nutrition and more selective use of parenteral nutrition based on gestational age, illness severity, and antenatal factors. This review synthesizes evidence guiding initial nutrition-defined as the period from birth to sustained full enteral feeding-with a focus on clinical application. We review enteral strategies including oropharyngeal colostrum administration, timing and volume of early feeds, duration of trophic feeding, early total enteral feeding, and feeding advancement rates, highlighting populations with robust evidence and those underrepresented in trials. Parenteral fluid practices are discussed in relation to physiologic postnatal weight loss, fetal growth restriction, and risks of both fluid overload and nutrient under delivery. We further address parenteral macronutrient and micronutrient provision, transition from parenteral to enteral nutrition, and limitations of peripheral parenteral nutrition delivery, noting areas reliant on expert consensus. We identify key evidence gaps and research priorities. Optimizing individualized initial nutrition strategies remains essential to improve growth, reduce morbidity, and support neurodevelopmental outcomes in preterm infants.
Low-dose aspirin in pregnancy: 81 mg vs 162 mg - Is there a role for personalized medicine?
Brewton A, Rood KM
Semin Perinatol · 2026 Jun · PMID 42321115 · Publisher ↗
Hypertensive disorders of pregnancy (HDP), including preeclampsia, remain major contributors to maternal and perinatal morbidity and mortality worldwide. Low-dose aspirin is the primary pharmacologic strategy for preecla...
Hypertensive disorders of pregnancy (HDP), including preeclampsia, remain major contributors to maternal and perinatal morbidity and mortality worldwide. Low-dose aspirin is the primary pharmacologic strategy for preeclampsia prevention in high-risk pregnancies; however, uncertainty persists regarding the optimal dose. In the United States, 81 mg daily remains standard practice, whereas emerging international evidence supports higher-dose strategies, including 150-162 mg. This review examines the biologic rationale, clinical evidence, and implementation considerations surrounding aspirin dosing in pregnancy, with emphasis on the potential role of personalized medicine. Mechanistically, aspirin exerts pleiotropic effects beyond platelet inhibition, including modulation of inflammatory and angiogenic pathways implicated in preeclampsia pathogenesis. Increasing evidence suggests that aspirin responsiveness may vary according to patient-level factors such as obesity, multifetal gestation, chronic hypertension, prior severe preeclampsia, and biologic variability in platelet turnover. Randomized trials and meta-analyses demonstrate a consistent signal toward improved efficacy with higher-dose aspirin in selected high-risk populations without clear increases in major adverse safety outcomes. Emerging biomarker-based screening models and implementation strategies, including electronic health record-supported risk stratification, may further enable individualized prophylaxis approaches. Future large pragmatic trials are needed to define optimal dosing strategies and ensure equitable implementation across diverse populations.
Nutrition beyond the neonatal intensive care unit: Best practices and optimal outcome measures.
Buck CO, Ong ML
Semin Perinatol · 2026 Jun · PMID 42321114 · Publisher ↗
Despite advancements in nutritional management during the neonatal intensive care unit hospitalization, preterm infants remain smaller than term-born counterparts at the time of hospital discharge. The goal for nutrition...
Despite advancements in nutritional management during the neonatal intensive care unit hospitalization, preterm infants remain smaller than term-born counterparts at the time of hospital discharge. The goal for nutritional management after discharge from the neonatal intensive care unit is to address ongoing nutrient and growth catch-up requirements and support growth and neurodevelopment while balancing the potential risks of too much growth. The current standard of care approach to post-hospitalization nutrition includes an individualized approach to nutritional supplementation with human milk fortification and/or nutrient enriched formulas, and incorporation of parental feeding choice and support of breastfeeding if desired into clinical decisions. Key gaps in the current literature include a need for evidence-based lactation and feeding support methods, and studies on a broad range of neonatal intensive care unit graduates, including those across the spectrum of prematurity and infants with other complex medical needs. Future research should aim for consistency in definitions of nutritional exposures and growth and developmental outcomes, involve parents in study design and choice of outcomes, and consider study design strategies which optimize longitudinal attrition rates. Addressing these gaps will provide clearer insights into the optimal nutritional strategy to improve long-term health outcomes for infants at the highest risk.
Further defining the role of low-dose aspirin in pregnancy: Addressing the current controversies.
Hoffman MK
Semin Perinatol · 2026 Jun · PMID 42321113 · Publisher ↗
Abstract loading — click title to view on PubMed.
Current barriers and opportunities in neonatal nutrition research.
Chetta K, Romero-Lopez M, Falciglia GH
Semin Perinatol · 2026 Jun · PMID 42321112 · Publisher ↗
Neonatal nutrition research is pivotal for optimizing long-term health outcomes in high-risk infants, particularly preterm and critically ill neonates, where the foundational "first 1000 days" concept increasingly links...
Neonatal nutrition research is pivotal for optimizing long-term health outcomes in high-risk infants, particularly preterm and critically ill neonates, where the foundational "first 1000 days" concept increasingly links early nutritional interventions to lifelong neurodevelopmental, metabolic, and socio-economic trajectories. Despite substantial advances, translating this evolving pre-clinical knowledge base into consistent clinical improvements remains slow. This review synthesizes persistent barriers hindering progress in the field, including inconsistent definitions and reporting standards for nutritional intake and growth metrics, inadequate electronic health record infrastructure for automated nutrient calculations across parenteral and enteral sources, restrictive regulatory and consent frameworks that limit equitable enrollment in high-risk populations, and mounting institutional pressures that erode the physician-scientist pipeline. Natural variability in human milk further complicates precise nutritional delivery, where nutrient delivery scales predictably with caloric density, yet routine direct measurement remains underutilized. To accelerate meaningful advancements, the field requires standardized reporting guidelines, enhanced decision-support tools, innovative trial designs, and strengthened career support for physician-scientists. Addressing these interconnected barriers through collaboration, technological integration, and multi-level policy reform holds the potential to shift neonatal nutrition science from incremental gains to rapid improvements in infant survival, growth, and lifelong health.
Aspirin and bleeding risk in pregnancy: a clinical review.
Sullivan CO, Merriam AA, Hoffman MK
Semin Perinatol · 2026 Jun · PMID 42315428 · Publisher ↗
Low-dose aspirin is recommended by nearly every major obstetric society for women at high risk of preeclampsia. There is consistent and robust data surrounding preeclampsia prevention, particularly severe early-onset dis...
Low-dose aspirin is recommended by nearly every major obstetric society for women at high risk of preeclampsia. There is consistent and robust data surrounding preeclampsia prevention, particularly severe early-onset disease; however, there are signals in the data that question the safety of continuation until delivery due to potential increased risk of bleeding. There is robust data from the non-pregnant population that demonstrates concern with long-term aspirin use and bleeding risk. The obstetric literature lacks such robust studies around bleeding concerns, particularly around the time of delivery in individuals using aspirin in pregnancy. This review provides a comprehensive, review of bleeding and hemorrhage risk associated with aspirin use in pregnancy and highlights the consideration for aspirin discontinuation prior to delivery.
MDRO infections in the NICU- The international perspective.
Dharmapalan D, Sinha N
Semin Perinatol · 2026 Jun · PMID 42264971 · Publisher ↗
Neonatal sepsis due to Multidrug resistant organisms (MDRO) is a huge burden in resource limited settings of South Asia and Africa. The epidemiology, risk factors, diagnostic and management challenges differ significantl...
Neonatal sepsis due to Multidrug resistant organisms (MDRO) is a huge burden in resource limited settings of South Asia and Africa. The epidemiology, risk factors, diagnostic and management challenges differ significantly in the resource limited settings as compared to the resource rich settings, particularly for Gram-negative MDROs. Lack of diagnostic facilities, limited access to therapeutic options, inability to effectively control horizontal transmission in the neonatal care units due to limited resources are major hurdles in combating MDRO infections in neonates. The low sensitivity of gold standard blood cultures and paucity of pharmacokinetic data in neonates make the overall picture grim. Research studies over the past decade have identified high resistance to the first line and second line treatment regimens recommended by the World Health Organisation (WHO). The progress towards finding customised solutions has been slow. Novel betalactam-betalactamase antibiotics are effective against several MDROs but are expensive. Repurposed antibiotics like fosfomycin and flomoxef hold promise as therapeutic options. The continued critical gaps need to be urgently addressed as national priorities and through international support and cooperation.
Disparities in low dose aspirin use for preeclampsia risk reduction and opportunities for improvement.
Teal EN, Gyamfi-Bannerman C
Semin Perinatol · 2026 May · PMID 42215364 · Publisher ↗
Low-dose aspirin (LDA) is a safe, inexpensive, and evidence-based intervention that reduces the risk of preeclampsia among pregnant individuals at elevated risk. Despite strong evidence and national guideline recommendat...
Low-dose aspirin (LDA) is a safe, inexpensive, and evidence-based intervention that reduces the risk of preeclampsia among pregnant individuals at elevated risk. Despite strong evidence and national guideline recommendations, implementation of LDA prophylaxis remains inconsistent, and emerging evidence suggests that disparities in LDA use may contribute to inequities in maternal health outcomes. This review summarizes the current literature on disparities in LDA use for preeclampsia prevention and explores opportunities for equitable implementation. Existing studies demonstrate disparities across multiple stages of the LDA prevention pathway, including preeclampsia risk identification, clinician counseling and prescribing, patient uptake, and adherence. National data suggest that Black and Hispanic patients, publicly insured patients, non-English-speaking patients, and individuals receiving care in resource-constrained settings may be less likely to receive or use LDA prophylaxis. Patients eligible based on multiple moderate-risk factors appear particularly vulnerable to missed prescribing opportunities. Importantly, disparities persist even after LDA recommendation, highlighting the role of barriers related to trust, communication, health literacy, and structural determinants of health. Conceptualizing LDA delivery as a multistep implementation process provides a framework for understanding how inequities emerge and propagate throughout the care continuum. Emerging quality improvement and implementation initiatives suggest that standardized risk screening, electronic health record tools, clinician education, multilingual patient resources, workflow redesign, and team-based care approaches may improve equitable delivery of LDA prophylaxis. However, long-term outcome data remain limited. Addressing disparities in preeclampsia prevention will require equity-centered implementation strategies that move beyond guideline dissemination alone and focus on ensuring consistent delivery of evidence-based care across diverse patient populations.
Re-evaluating the impact of prenatal low-dose aspirin on child neurodevelopment.
Zhu J, Wang Y, Liu Z … +1 more , Zhang J
Semin Perinatol · 2026 May · PMID 42191540 · Publisher ↗
Prophylactic use of low-dose aspirin starting from 12 weeks of gestation has been recommended to women at high risk of preeclampsia by clinical guidelines. Aspirin can cross the placenta and may exert its pharmacological...
Prophylactic use of low-dose aspirin starting from 12 weeks of gestation has been recommended to women at high risk of preeclampsia by clinical guidelines. Aspirin can cross the placenta and may exert its pharmacological effects on both the mother and the fetus. However, it remains uncertain whether prenatal low-dose aspirin exposure has influences on child neurodevelopment. Current evidences indicate that prenatal low-dose aspirin exposure is not associated with harmful effects and may even offer potential benefits on child neurodevelopment. This article reviews pharmacokinetic characteristics of aspirin in maternal and fetal circulation and discusses potential pathways between prenatal aspirin exposure and child neurodevelopment. Due to the deficiencies in current studies, further observational and experimental studies are warranted to explore the influence and underlying mechanisms of prenatal low-dose aspirin on child neurodevelopment.
Metabolic bone disease of prematurity: current knowledge, controversies, and research priorities.
Romero-Lopez M, Thoene M, Ottolini K … +1 more , Taylor S
Semin Perinatol · 2026 May · PMID 42177098 · Publisher ↗
Despite decades of research and significant improvements in neonatal nutrition, clinicians still struggle with fundamental questions about metabolic bone disease of prematurity diagnosis, treatment, and long-term consequ...
Despite decades of research and significant improvements in neonatal nutrition, clinicians still struggle with fundamental questions about metabolic bone disease of prematurity diagnosis, treatment, and long-term consequences. This review examines what we know about metabolic bone disease of prematurity, the gaps in our understanding, and highlights the controversies in clinical practice. Typical practices include biochemical screening, which may begin at 3-4 weeks for at-risk infants, with alkaline phosphatase and phosphate levels serving as primary markers of disease. Nutritional optimization through adequate parenteral and enteral provisions, such as via fortified human milk or specialized preterm formulas, represents the main prevention and treatment approach. However, given the lack of consensus on diagnostic thresholds and definitions for metabolic bone disease of prematurity, there remain inconsistent prevention and treatment strategies. This review offers practical guidance based on current evidence, while identifying critical areas where additional research is needed to continue to improve outcomes.
Universal vs risk-based aspirin prophylaxis in pregnancy: Time for a paradigm shift?
Jones Pullins M, Boggess K
Semin Perinatol · 2026 May · PMID 42168033 · Publisher ↗
Low-dose aspirin is an evidence-based intervention that reduces the risk of preeclampsia and related maternal morbidity. Current U.S. guidelines recommend a risk-based approach, targeting individuals at high or moderate...
Low-dose aspirin is an evidence-based intervention that reduces the risk of preeclampsia and related maternal morbidity. Current U.S. guidelines recommend a risk-based approach, targeting individuals at high or moderate risk. However, implementation remains inconsistent, and risk stratification may fail to identify a substantial proportion of patients who ultimately develop preeclampsia. This paper evaluates the evidence supporting low-dose aspirin, the limitations of current risk-based strategies, and the potential benefits and harms of a universal prophylaxis approach. We argue that universal aspirin prophylaxis offers advantages in simplicity, equity, and implementation.
Beyond preeclampsia: low dose aspirin as a preventative strategy for spontaneous preterm birth.
Lamens JT, Meliëzer JAL, Oudijk MA … +1 more , de Boer MA
Semin Perinatol · 2026 May · PMID 42144301 · Publisher ↗
Spontaneous preterm birth (PTB) remains a substantial challenge in healthcare worldwide. The etiology is multifactorial and includes placental insufficiency, which overlaps with the pathophysiology of preterm pre-eclamps...
Spontaneous preterm birth (PTB) remains a substantial challenge in healthcare worldwide. The etiology is multifactorial and includes placental insufficiency, which overlaps with the pathophysiology of preterm pre-eclampsia (PE). Low-dose aspirin (LDA) is an established preventative strategy for preterm PE by targeting placental insufficiency. This narrative summarizes current evidence for LDA as a preventive strategy for spontaneous PTB. In patients at risk of preterm PE, daily LDA (particularly when initiated before 16 weeks of gestation and at a dose ≥100 mg) prevents total PTB. Emerging evidence suggests that daily LDA also reduces total PTB in nulliparous patients. However, findings have not been confirmed in national cohort studies, largely due to suboptimal treatment adherence. Recent studies also suggest a preventive effect of LDA in patients with a history of spontaneous PTB, although these studies are underpowered to draw firm conclusions. Overall, trends point towards a preventive effect of LDA, providing a safe and inexpensive treatment for spontaneous PTB. The effectiveness may be limited to subgroups based on the underlying mechanism of spontaneous PTB. Future research should focus on large population-based implementation studies focusing on treatment adherence, as well as identifying subgroups most likely to benefit from LDA.
Rebalancing prostanoids: How differential COX-1 and COX-2 inhibition explains the success and limitations of low-dose aspirin in pregnancy.
Moriarty KL, Boelig RC
Semin Perinatol · 2026 May · PMID 42143000 · Publisher ↗
Preeclampsia presents a major health impact to the maternal-fetal dyad and poses a maternal mortality risk estimated to be 5-15% worldwide, with diagnosis rates for this disorder substantially increasing. This disorder c...
Preeclampsia presents a major health impact to the maternal-fetal dyad and poses a maternal mortality risk estimated to be 5-15% worldwide, with diagnosis rates for this disorder substantially increasing. This disorder continues to pose a substantial economic burden, with costs estimated at 2.18 billion dollars within the first year postpartum. Despite the dramatic annual impact of preeclampsia, the pathophysiology of this disorder remains poorly understood. Low-dose aspirin (LDA) is the sole primary therapy for the prevention of preeclampsia. The mechanism of action of LDA on the cyclooxygenase isoform, COX-1, and its limited interaction with COX-2 help explain its treatment approach and shortcomings. Important questions remain regarding LDA therapy with respect to its efficacy, optimal timing of initiation, and dosing regimens required to achieve maximal therapeutic benefit. In this review, we explore the pathophysiology of preeclampsia, with attention to the cyclooxygenase pathway as a means of refining understanding of aspirin's mechanism of action, informing potential dosing strategies, and discussing alternative therapies and future directions for preeclampsia treatment.
Candida auris in the neonatal intensive care unit.
L'Etoile N, Murray TS
Semin Perinatol · 2026 May · PMID 42142999 · Publisher ↗
Candida (a.k.a.Candidozyma) auris is a healthcare-associated yeast that has attracted attention due to its increased antimicrobial resistance and ability to spread rapidly within the healthcare environment. Infants admit...
Candida (a.k.a.Candidozyma) auris is a healthcare-associated yeast that has attracted attention due to its increased antimicrobial resistance and ability to spread rapidly within the healthcare environment. Infants admitted to the neonatal intensive care unit (NICU) have risk factors such as broad spectrum antibiotic exposure, prematurity and congenital heart disease that predispose them to serious infection with C. auris. Consequently, there have been global reports of C. auris outbreaks in NICUs associated with high mortality. The clinical presentation of late onset sepsis with C. auris is indistinguishable from other etiologies. Echinocandins remain the empiric therapy of choice along with amphotericin B in select cases. Identification of an invasive case of C. auris in the NICU requires implementation of infection prevention and control measures including contact precautions, enhanced environmental cleaning and disinfection, and the screening of other infants for colonization. Areas where research is needed include optimal antifungal therapy for treatment and prophylaxis, the ideal body sites to screen for colonization, the length of time infants remain colonized with C. auris, and the risk of infant colonization from breast feeding and skin-to-skin practices with colonized or infected caregivers. Continued reporting of the clinical experience of NICUs that experience C. auris is essential to expand our knowledge and to protect neonates and infants from this evolving pathogen.
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