Liver ultrasonography should be performed in all the neonates with signs of sepsis, especially in the presence of candidemia and/or hepatomegaly and/or significant change in liver enzymes. Umbilical venous catheter should be removed, and peripheral IV access should be used until there is documented clearance from the blood with three or more negative blood cultures.

Introduction: Systemic fungal disease, by Candida species, are a much feared complication in NICU. Objectives: We evaluated the higher incidence of Candida A. infection and not particularly in VLBW and ELBW infants. Methods: Infection cases by Candida albicans and not recorded in NICU of Messina. Results: The cases were reported 42/1839 (2%) 21 premature infants , G.A. 30.5± 3.78 , weight 1550.4 ± 906.9, 14 term infants , G.A. 38.42 ± 1:45,weight 3128.9 ± 290.8 , 7 pediatric patients. The fungus most frequently isolated was Candida parapsilosis (19/42-46%), followed by C. albicans (13/42-32%), by C. lambica (5/42-12%), C. tropicalis (2/42-4%), C.zeylanoides (1/42-2%), C.krusei (1/42-2%), C.guillermondi (1/42-2%). Of the 15 preterm with GA ≤ 32, in 8 / 15 (53%) was isolated C.parapsilosis, in 4 / 15 (27%) C. albicans ,in 2 / 15 (13%) C.lambica, in one case (1 / 15-7%) C.zeylanoides. About patients studied 7 / 42 died (17%) which 6 / 21 preterm infants (28%), 1 / 7 pediatric patients (14%), no term baby died. We have registered two cases of mycetoma in a preterm baby. Conclusions: The increased incidence of Candida parapsilosis is a main cause of infections, linked to fungal adherence ability to prosthetic materials and to proliferate in presence of high glucose concentrations , especially in preterm infants in parenteral nutrition. Our study shown the problem of colonization,the selection of resistant strains of Candida in NICU and its new therapeutic options.