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Intestinal microbial ecology and environmental factors affecting necrotizing enterocolitis

Roberto Murgas Torrazza1, Maria Ukhanova2, Xiaoyu Wang2

  • 1Department of Pediatrics, College of Medicine University of Florida, Gainesville, Florida, United States of America.

Plos One
|January 4, 2014
PubMed

Insights

Necrotizing enterocolitis (NEC) in preterm infants is linked to specific gut bacteria. Early life antibiotic use and feeding type influence this microbial imbalance, increasing NEC risk.

Area of Science:

  • Neonatal Medicine
  • Microbiome Research
  • Pediatric Gastroenterology

Background:

  • Necrotizing enterocolitis (NEC) is a severe intestinal disease in preterm infants, causing mortality and long-term health issues.
  • The pathogenesis of NEC is complex, with emerging evidence implicating gut dysbiosis, influenced by antibiotics and feeding practices.
  • The role of specific infectious agents and early microbial colonization patterns in NEC development remains poorly understood.

Purpose of the Study:

  • To investigate the association between gut microbiota composition and the development of NEC in preterm infants.
  • To identify specific microbial signatures or shifts preceding NEC diagnosis.
  • To evaluate the impact of environmental factors like antibiotic use and feeding type on NEC-associated dysbiosis.

Main Methods:

  • Analysis of fecal samples from preterm infants (≤ 32 weeks gestation) using 16S rRNA sequencing at multiple time points before NEC diagnosis.
  • Comparison of microbiota composition between NEC cases (n=18) and controls (n=35).
  • Evaluation of environmental factors including antibiotic usage, feeding type (human milk vs. formula), and neonatal intensive care unit (NICU) location.

Main Results:

  • Significant differences in microbiota composition were observed between NICUs, correlating with antibiotic usage patterns.
  • NEC cases showed a higher proportion of Proteobacteria and Actinobacteria, and lower Bifidobacteria and Bacteroidetes counts in the weeks preceding NEC diagnosis compared to controls.
  • A novel bacterial signature, similar to Klebsiella pneumoniae, was detected in early fecal samples and strongly associated with later NEC development.

Conclusions:

  • Infants who develop NEC exhibit distinct gut microbial colonization patterns compared to healthy preterm infants.
  • Antibiotic exposure and feeding type are critical factors influencing gut microbiota and likely play a significant role in NEC pathogenesis.
  • Early identification of specific microbial signatures may aid in predicting NEC risk in vulnerable preterm infants.

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