Background Invasive Candida species have become a common cause of late-onset sepsis in neonatal intensive care units. Significant risk factors include low birth weight, exposure to broad spectrum antibiotics, parenteral nutrition, lipid emulsion, central venous catheter and abdominal surgery.

Material and method We performed a retrospective study over a period of 12 years (Jan 2002 to Jan 2014) in our hospital NICU. The aims of this study were to investigate the incidence of the systemic candidiasis, mortality rate, the implicated Candida strains, specific risk factors and antifungal treatment.

Results All of our cases were outpatients. The average incidence of systemic candidiasis was 5.8% (111 cases) with a specific average mortality of 28%. In 96 cases (86.5%) not albicans Candida species were identified. 83 patients (74.7%) underwent abdominal surgery interventions; from these 42 had malformations of digestive tract and 16 presented abdominal wall defects. 12 operated patients remained with temporary ileostomies, 5 had colostomies and 4 cases associated short bowel syndrome. Also 23 (20.7%) were premature with birth weight under 1500 g; 25 cases presented also a bacterial sepsis. The antifungal therapy consisted of Fluconazol iv during the period 2002–2006; starting 2007 we used mainly Caspofungin iv. Also, starting 2011 all the patients with risk factors received oral prophylaxis with Nistatin.

Conclusions Neonatal sepsis with Candida species still has a high rate of mortality and morbidity mainly linked of specific risk factors and other severe illnesses. Thereof more randomised trials regarding both oral and iv prophylaxis are needed.