First case report of concurrent infection with Cupriavidus gilardii and Yarrowia lipolytica following esophageal stenosis resection and anastomosis in a newborn

Cupriavidus gilardii and Yarrowia lipolytica are recognized as opportunistic pathogens with a low incidence of human infections. Notably, cases involving concurrent infection by these two pathogens have not been previously documented in the literature. We present a case of a 1-month-old male neonate who developed concurrent infection with C. gilardii and Y. lipolytica following surgical resection and anastomosis for congenital esophageal stenosis. The patient developed a postoperative pulmonary infection and subsequent microbiological culture of thoracic drainage fluid confirmed the presence of both C. gilardii and Y. lipolytica. Based on the results of antimicrobial susceptibility testing (AST), the neonate was treated with a combined antimicrobial regimen comprising cefoperazone/sulbactam and fluconazole, and resulting in full clinical and microbiological recovery. To the best of our knowledge, this is the first reported case of a human co-infected with C. gilardii and Y. lipolytica. The clinical course of this case underscores the indispensable role of microbiological laboratory diagnostics in facilitating accurate diagnosis and informing targeted therapeutic strategies. Timely identification and confirmation of pathogen, combined with in vitro AST, can provide active guidance for anti-infective therapy. For immunocompromised patients, high-risk factors predisposing to nosocomial infections such as intubation should be eliminated as soon as possible. Such systematic approaches are essential to avert significant therapeutic delays, prevent clinical deterioration, and avoid futile treatments attributable to unidentified or misidentified pathogens. Not applicable.