The preterm gut microbiota: changes associated with necrotizing enterocolitis and infection

Acta Paediatr. 2012 Nov;101(11):1121-7. doi: 10.1111/j.1651-2227.2012.02801.x. Epub 2012 Aug 31.

Abstract

Aim: To describe gut colonization in preterm infants using standard culture and 16S gene rRNA profiling, exploring differences in healthy infants and those who developed NEC/late onset sepsis (LOS).

Methods: Ninety-nine stools from 38 infants of median 27-week gestation were cultured; 44 stools from 27 infants had their microbial profiles determined by 16S. Ordination analyses explored effects of patient variables on gut communities.

Results: Standard microbiological culture identified a mean of two organisms (range 0-7), DGGE 12 (range 3-18) per patient. Enterococcus faecalis and coagulase negative staphylococci (CONS) were most common by culture (40% and 39% of specimens). Meconium was not sterile. No fungi were cultured. Bacterial community structures in infants with NEC and LOS differed from healthy infants. Infants who developed NEC carried more CONS (45% vs 30%) and less Enterococcus faecalis (31% vs 57%). 16S identified Enterobacter and Staphylococcus presence associated with NEC/LOS, respectively.

Conclusions: Important differences were found in the gut microbiota of preterm infants who develop NEC/LOS. The relationship of these changes to current practices in neonatal intensive care requires further exploration.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Case-Control Studies
  • DNA, Bacterial / analysis
  • Denaturing Gradient Gel Electrophoresis
  • Enterococcus faecalis / genetics
  • Enterococcus faecalis / isolation & purification*
  • Enterocolitis, Necrotizing / microbiology*
  • Feces / microbiology*
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / microbiology*
  • Male
  • Multivariate Analysis
  • Principal Component Analysis
  • RNA, Ribosomal, 16S
  • Sepsis / microbiology*
  • Staphylococcus / genetics
  • Staphylococcus / isolation & purification*

Substances

  • DNA, Bacterial
  • RNA, Ribosomal, 16S