Urinary D-lactate excretion in infants with necrotizing enterocolitis.

Area of Science:

• Biochemistry
• Neonatal Medicine
• Microbiology

Background:

• Necrotizing enterocolitis (NEC) is a severe gastrointestinal emergency in neonates.
• Accurate diagnostic markers for NEC are crucial for timely intervention.
• Increased enteric bacterial activity is implicated in NEC pathogenesis.

Purpose of the Study:

• To investigate urinary D-lactate/creatinine ratio (uDL/CR) as a potential biomarker for NEC.
• To correlate uDL/CR levels with the presence and severity of NEC in infants.

Main Methods:

• Serial measurement of urinary D-lactate/creatinine ratio (uDL/CR).
• Comparison of uDL/CR in infants with NEC, healthy infants, and sick infants without NEC.
• Analysis of uDL/CR trends during disease onset, peak, and recovery phases.

Main Results:

• Infants with NEC exhibited significantly higher mean uDL/CR (1.63 +/- 1.09) compared to healthy (0.16 +/- 0.04) and sick non-NEC infants (0.43 +/- 0.32).
• A peak uDL/CR of 1.47 was reached or exceeded by 7/9 infants with NEC, but by none without NEC.
• uDL/CR levels correlated with NEC disease progression, rising at onset and subsiding with recovery.

Conclusions:

• Elevated urinary D-lactate/creatinine ratio is a sensitive indicator of necrotizing enterocolitis in infants.
• Increased uDL/CR reflects heightened enteric bacterial activity associated with NEC.
• uDL/CR shows potential as a non-invasive diagnostic tool for NEC.