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Role of micro-organisms in necrotizing enterocolitis
David C A Candy1, Seán P Devane1
1Department of Child Health, King's College School of Medicine and Dentistry, and King's Healthcare Trust, Denmark Hill, London SE5 9RS, UK.
Seminars in Neonatology : SN
|April 15, 2020
Summary
Necrotizing enterocolitis (NEC) in preterm infants may stem from infections due to their immature gastrointestinal defenses. Identifying infectious agents and inflammatory mediators is key to preventing this serious condition.
Area of Science:
- Neonatal Medicine
- Pediatric Gastroenterology
- Infectious Diseases
Background:
- Preterm infants have immature gastrointestinal defenses, increasing susceptibility to bacterial overgrowth.
- Necrotizing enterocolitis (NEC) outbreaks suggest an infectious etiology.
- Pathogenic bacteria and viruses are frequently implicated in NEC.
Purpose of the Study:
- To explore the infectious origins of necrotizing enterocolitis in preterm infants.
- To identify key bacterial and viral agents contributing to NEC.
- To investigate the role of bacterial metabolites and inflammatory mediators in NEC pathogenesis.
Main Methods:
- Isolation and histological detection of pathogenic bacteria and viruses in affected infants.
- Analysis of breath, intestinal gas, and urine for bacterial metabolites (hydrogen, D-lactate).
- Review of evidence linking bacterial products and inflammatory mediators to intestinal ischemia.
Main Results:
- A wide range of pathogens identified in NEC cases.
- Detection of bacterial metabolites in affected infants confirms gut dysbiosis.
- Bacterial products and inflammatory mediators contribute to intestinal ischemia in NEC.
Conclusions:
- Necrotizing enterocolitis likely has an infectious component.
- Understanding inflammatory pathways is crucial for NEC management.
- Future prevention strategies should focus on breast milk, nutritional support, and immunotherapies.
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