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Published on: July 28, 2023
Molecular testing for gastrointestinal pathogens in intestinal tissue of infants with necrotizing enterocolitis or
Maria M Talavera-Barber1, Pablo J Sánchez2,3,4, Miriam Conces5
1Department of Pediatrics, Avera Research Institute and University of South Dakota Sanford School of Medicine, Sioux Falls, SD, USA. Maria.Barber@avera.org.
Objective:
The objective of this study was to determine the frequency of common gastrointestinal bacterial, parasitic, and viral pathogen detection in necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP) -associated intestinal tissue.
Study Design:
Retrospective cohort study examined formalin fixed, paraffin embedded (FFPE) surgical or autopsy intestinal tissue from NEC or SIP specimens. DNA and RNA were extracted and analyzed by multiplex PCR panel (GIFA Biofire). DNA or RNA from stool samples containing each pathogen were extracted for positive controls.
Results:
The total number of intestinal tissue samples were 193 from 310 infants (156 NEC, 37 SIP). Six (3%) infants with stage III NEC tested positive for a target pathogen; 2, C. difficile; 3, Enteroaggregtive E. coli; and 1, Giardia. No gastrointestinal viral pathogens were detected.
Conclusion:
Molecular testing yielded few GI pathogens suggesting that these organisms are likely not major causes or facilitators of NEC or SIP.
Insights
Molecular testing found few gastrointestinal pathogens in intestinal tissue from infants with necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP). This suggests these microbes are unlikely major causes of these serious infant conditions.
Area of Science:
- Neonatalogy
- Gastroenterology
- Molecular Diagnostics
Background:
- Necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP) are critical conditions in neonates.
- The role of specific gastrointestinal pathogens in NEC and SIP pathogenesis remains unclear.
Purpose of the Study:
- To investigate the frequency of common bacterial, parasitic, and viral pathogen detection in intestinal tissue associated with NEC or SIP.
Main Methods:
- Retrospective analysis of 193 intestinal tissue samples from 310 infants (156 NEC, 37 SIP).
- Multiplex PCR (GIFA Biofire) was used to detect pathogen DNA and RNA in formalin-fixed, paraffin-embedded tissue.
- Positive controls were prepared from stool samples containing target pathogens.
Main Results:
- Only 6% (6/193) of infant intestinal tissue samples tested positive for a target pathogen.
- Detected pathogens included *Clostridioides difficile* (2 infants), enteroaggregative *E. coli* (3 infants), and *Giardia* (1 infant).
- No gastrointestinal viral pathogens were detected in any of the samples.
Conclusions:
- The low detection rate of common GI pathogens suggests they are not major contributors to NEC or SIP.
- Further research may be needed to explore other etiological factors in NEC and SIP.
