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Related Experiment Videos

Enterobacteriaceae and neonatal necrotising enterocolitis.

M R Millar1, P MacKay, M Levene

  • 1Department of Microbiology, General Infirmary, Leeds.

Archives of Disease in Childhood
|January 1, 1992
PubMed
Summary

Vancomycin and aztreonam treatment in premature neonates reduced gut bacteria and prevented necrotising enterocolitis. Vancomycin and gentamicin did not reduce gut bacteria and were associated with increased necrotising enterocolitis incidence.

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Area of Science:

  • Neonatal Intensive Care
  • Microbiology
  • Pediatric Infectious Diseases

Background:

  • Necrotising enterocolitis (NEC) is a severe gastrointestinal emergency in premature infants.
  • Bowel colonization patterns may influence NEC development.
  • Antibiotic selection for suspected sepsis in neonates requires careful consideration of gut microbiome impact.

Purpose of the Study:

  • To compare the effects of vancomycin/aztreonam versus vancomycin/gentamicin on bowel colonization in neonates.
  • To assess the incidence of necrotising enterocolitis (NEC) in neonates receiving these antibiotic regimens.

Main Methods:

  • Randomized controlled trial in neonates (<33 weeks gestational age) requiring mechanical ventilation.
  • Antibiotic regimens (vancomycin/aztreonam or vancomycin/gentamicin) administered for suspected sepsis after the first week of life.

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  • Fecal samples analyzed for bacterial colonization (Enterobacteriaceae, anaerobes, Enterococcus, Staphylococcus, yeasts) at weeks 2, 3, and 4.

    • Main Results:

    • Vancomycin/aztreonam led to a rapid reduction in fecal Enterobacteriaceae colonization.
    • Vancomycin/gentamicin resulted in higher Enterobacteriaceae colonization rates and no quantitative reduction.
    • No significant differences in colonization by anaerobes, Enterococcus, Staphylococcus, or yeasts were observed.
    • NEC incidence was 0% in the vancomycin/aztreonam group versus 14.6% in the vancomycin/gentamicin group.

    Conclusions:

    • Vancomycin and aztreonam effectively reduce Enterobacteriaceae gut colonization in high-risk neonates.
    • Vancomycin and gentamicin treatment is associated with increased NEC risk in this population.
    • Antibiotic choice significantly impacts gut microbiome and NEC outcomes in premature infants.