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Necrotising enterocolitis: is there a relationship to specific pathogens?

C S Peter¹, M Feuerhahn, B Bohnhorst

¹Department of Paediatric Pulmonology, Medizinische Hochschule Hannover, Germany.

European Journal of Pediatrics

|February 9, 1999

Summary

Necrotising enterocolitis (NEC) in premature infants is not linked to specific pathogens, despite gut colonization by potential pathogens being common. This prospective study found no specific bacterial association with NEC development in neonates.

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Area of Science:

Neonatal Medicine
Infectious Diseases
Gastroenterology

Background:

Necrotising enterocolitis (NEC) is a serious condition in premature infants.
Previous studies suggest a link between NEC outbreaks and specific pathogens like Enterobacteriaceae, but evidence is often retrospective and inconclusive.

Purpose of the Study:

To prospectively investigate the association between specific bacterial pathogens and the development of necrotising enterocolitis (NEC) in preterm neonates.
To compare the gut microbiome of infants who developed NEC with that of matched controls.

Main Methods:

A prospective study was conducted from April 1993 to March 1997.
Stool samples from neonates (< 36 weeks gestation) were collected weekly and analyzed for bacteria.
Infants who developed NEC were compared to two age- and admission-date-matched control infants.

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Main Results:

Eighteen infants experienced 19 episodes of NEC; 8 required surgery, and 2 died.
Infants with NEC had more severe respiratory distress syndrome and a higher proportion were exclusively formula-fed.
Potentially pathogenic bacteria were found in all NEC cases and 79% of controls in the week prior to NEC onset (P < 0.05).
No significant differences were observed in the occurrence of specific pathogens or pathogen groups between NEC cases and controls.

Conclusions:

Gut colonization with potential pathogens appears necessary for NEC development.
However, this study found no specific bacteria uniquely associated with necrotising enterocolitis when comparing cases to matched controls.