Having been taught from an early and impressionable age that the first answer to most questions in neonatology is “infection”, it is discouraging that, despite many years of advances in neonatal intensive care, the diagnosis and treatment of infection remains a considerable challenge. This is particularly true of the extreme preterm infant, whose improved survival is accompanied by an increase in nosocomial infections. Many units throughout the world have seen an extension of the antimicrobial repertoire as organisms become increasingly resistant to conventional broad spectrum antibiotics.

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