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Updated: Jan 30, 2026
Murine Fecal Isolation and Microbiota Transplantation
Published on: May 26, 2023
Enteric dysbiosis and fecal calprotectin expression in premature infants
Thao T B Ho1, Maureen W Groer2, Bradley Kane2
1Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
Insights
In premature infants, fecal calprotectin (a marker of inflammation) correlated with the bacteria Klebsiella, not the broader Gammaproteobacteria group. This suggests a need for more specific definitions of infant gut dysbiosis.
Area of Science:
- Microbiology
- Neonatology
- Gastroenterology
Background:
- Premature infants frequently exhibit enteric dysbiosis, characterized by an overgrowth of Gammaproteobacteria.
- This dysbiosis is linked to negative clinical outcomes in neonates.
- The relationship between specific bacterial groups and mucosal inflammation in premature infants requires further investigation.
Purpose of the Study:
- To investigate the association between increasing fecal Gammaproteobacteria and mucosal inflammation in very-low-birth weight (VLBW) infants.
- To determine if fecal calprotectin (FC), a marker of mucosal inflammation, correlates with the abundance of Gammaproteobacteria in the infant gut microbiome.
Main Methods:
- Stool samples were collected from 45 VLBW infants at multiple postnatal ages (≤2, 3, and 4 weeks).
- Fecal microbiome composition was analyzed using 16S ribosomal RNA gene sequencing (V4 region).
- Fecal calprotectin (FC) levels were quantified using enzyme immunoassay.
Main Results:
- Fecal calprotectin (FC) showed a positive correlation with the bacterial genus Klebsiella and its dominant amplicon sequence variant.
- No significant correlation was found between FC and the overall relative abundance of the class Gammaproteobacteria.
- Klebsiella colonization patterns varied, with some infants showing a gradual increase and others presenting with high initial abundance.
Conclusions:
- In premature infants, mucosal inflammation (measured by FC) is associated with the specific pathobiont Klebsiella, rather than the broader Gammaproteobacteria class.
- These findings highlight the importance of defining dysbiosis at a genus or higher taxonomic resolution for accurate clinical assessment.
- Further research is needed to understand the specific role of Klebsiella in neonatal gut health and disease.
Background:
Premature infants often develop enteric dysbiosis with a preponderance of Gammaproteobacteria, which has been related to adverse clinical outcomes. We investigated the relationship between increasing fecal Gammaproteobacteria and mucosal inflammation, measured by fecal calprotectin (FC).
Methods:
Stool samples were collected from very-low-birth weight (VLBW) infants at ≤2, 3, and 4 weeks' postnatal age. Fecal microbiome was surveyed using polymerase chain reaction amplification of the V4 region of 16S ribosomal RNA, and FC was measured by enzyme immunoassay.
Results:
We enrolled 45 VLBW infants (gestation 27.9 ± 2.2 weeks, birth weight 1126 ± 208 g) and obtained stool samples at 9.9 ± 3, 20.7 ± 4.1, and 29.4 ± 4.9 days. FC was positively correlated with the genus Klebsiella (r = 0.207, p = 0.034) and its dominant amplicon sequence variant (r = 0.290, p = 0.003), but not with the relative abundance of total Gammaproteobacteria. Klebsiella colonized the gut in two distinct patterns: some infants started with low Klebsiella abundance and gained these bacteria over time, whereas others began with very high Klebsiella abundance.
Conclusion:
In premature infants, FC correlated with relative abundance of a specific pathobiont, Klebsiella, and not with that of the class Gammaproteobacteria. These findings indicate a need to define dysbiosis at genera or higher levels of resolution.
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