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J Pediatr Surg. 2017 Jun;52(6):993-998. doi: 10.1016/j.jpedsurg.2017.03.029. Epub 2017 Apr 5.

Independence of gut bacterial content and neonatal necrotizing enterocolitis severity.

Author information

1
Division of Pediatric Surgery, Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis Children's Hospital, St. Louis, MO, USA.
2
Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, MO, USA.
3
Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, MO, USA.
4
Department of Medicine, Washington University School of Medicine in St Louis, St Louis, MO, USA.
5
Division of Pediatric Surgery, Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis Children's Hospital, St. Louis, MO, USA. Electronic address: Brad.Warner@wustl.edu.

Abstract

INTRODUCTION:

Necrotizing enterocolitis (NEC) is a common and devastating gastrointestinal disease of premature infants. NEC severity varies widely. Recent data have demonstrated a strong link between gut microbial dysbiosis and development of NEC. We tested the hypothesis that alterations in the gut microbiome at the time of diagnosis predict the severity of NEC.

METHODS:

We used prospectively collected fecal samples from very low birth weight infants who developed NEC, stratifying by NEC severity. Fecal bacterial DNA was sequenced using 16S rRNA pyrosequencing. A generalized Wald-type test based on the Dirichlet multinomial distribution was used to test for differences in microbial communities.

RESULTS:

Of 489 infants at risk, 30 NEC cases had 410 fecal samples collected in the 28days prior to the onset of NEC available for analysis. There were no differences in the pre-NEC gut microbial community between infants treated medically vs. surgically, or those with NEC totalis. Furthermore, neither treatment of NEC significantly changed the gut microbiome post-NEC among the survivors.

CONCLUSION:

We found no evidence that the gut microbiome, prior to the onset of disease, differentiates the clinical course of NEC. These data suggest that factors other than the gut microbiome may dictate disease severity.

LEVEL OF EVIDENCE:

Level 4.

KEYWORDS:

Microbiome; Necrotizing enterocolitis; Small bowel resection

PMID:
28410788
PMCID:
PMC5473614
DOI:
10.1016/j.jpedsurg.2017.03.029
[Indexed for MEDLINE]
Free PMC Article

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