Infants born before 24 weeks' gestational age face unique challenges compared to more mature preterm infants. This includes a higher risk of infection, which remains a leading cause of morbidity and mortality. Over the last two decades, advancements in neonatal care have resulted in higher rates of survival. However, invasive bacterial and fungal infections continue to pose significant threats. This narrative review highlights the epidemiology, microbiology, and related outcomes of bacterial and fungal infections in infants born before 24 weeks' gestational age. This review also discusses major knowledge gaps in infection epidemiology, prevention, and management, highlighting the need for more robust international data and innovative strategies to address the unique vulnerabilities of these infants.
© 2026. The Author(s).