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Multiple Opportunistic Pathogens, but Not Pre-existing Inflammation, May Be Associated with Necrotizing Enterocolitis

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Abstract

Background

Necrotizing enterocolitis (NEC) leads to significant morbidity and mortality in the neonatal intensive care unit. Although current evidence would suggest that bacteria contribute to the pathogenesis of NEC, no single bacterium has yet been identified.

Aims

The aims of this study were to investigate fecal S100A12 concentrations and the intestinal bacterial community in premature infants (24–32 weeks) and investigate any associations between the microbiota and the development of NEC.

Methods

Meconium and feces were collected from premature newborn infants (between 24 and 32 weeks gestation) over the first 4 weeks of life. Fecal S100A12 concentrations were assayed by immunoassay, and samples were subject to 16S rDNA analysis using next-generation sequencing techniques.

Results

Fecal samples were collected from four infants that developed NEC and 18 control infants. Prior to developing NEC, fecal S100A12 concentrations were not elevated; however, following NEC diagnosis, concentrations were highly elevated. The fecal bacterial communities of infants with NEC did not differ significantly from control infants. However, potentially pathogenic bacteria were detected in significantly more infants with NEC than in controls (p = 0.0007).

Conclusion

At birth, fecal S100A12 concentrations were not elevated in premature infants subsequently developing NEC in this cohort. Following NEC diagnosis, S100A12 concentrations were highly elevated, suggesting that this potentially could act as a marker of disease progression. Higher detection rates of potentially pathogenic bacteria in NEC infants suggest that a range of potentially pathogenic bacteria may collectively contribute to NEC pathogenesis.

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Acknowledgments

We thank Ananthaen Killikulangara, Ben Rayner, Catherine Smith, and Fathalla Ali for assisting with sample and data collection and processing. Laboratory work was undertaken in the Westfield Research Laboratories in Sydney Children’s Hospital.

Author information

Authors and Affiliations

  1. School of Women’s and Children’s Health, University of New South Wales, High Street, Sydney, NSW, 2031, Australia

    Steven T. Leach, Kei Lui & Andrew S. Day

  2. Department of Newborn Care, Royal Hospital for Women, Sydney, Australia

    Kei Lui

  3. Virology, Department of Microbiology, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, Australia

    Zin Naing

  4. Molecular Research LP, MR DNA, Shallowater, TX, USA

    Scot E. Dowd

  5. School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, Australia

    Hazel M. Mitchell

  6. Department of Paediatrics, University of Otago, Christchurch, New Zealand

    Andrew S. Day

Authors
  1. Steven T. Leach
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  2. Kei Lui
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  3. Zin Naing
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  4. Scot E. Dowd
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  5. Hazel M. Mitchell
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  6. Andrew S. Day
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Corresponding author

Correspondence to Steven T. Leach.

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Conflicts of Interest and Source of Funding

Funding for this project was provided by the Sydney Children’s Hospital Foundation, the Leslie Stevens Fund for Newborn Care, and the Madison Capaldi Research Fund, Royal Hospital for Women Foundation. The authors have no conflicts of interest.

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Leach, S.T., Lui, K., Naing, Z. et al. Multiple Opportunistic Pathogens, but Not Pre-existing Inflammation, May Be Associated with Necrotizing Enterocolitis. Dig Dis Sci 60, 3728–3734 (2015). https://doi.org/10.1007/s10620-015-3830-6

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  • DOI: https://doi.org/10.1007/s10620-015-3830-6

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