Department of Human Nutrition, University of Copenhagen, DK-1870 Frederiksberg, Denmark.
Pediatr Res. 2011 Jan;69(1):10-6. doi: 10.1203/PDR.0b013e3181ff2a89.
Necrotizing enterocolitis (NEC) in preterm neonates is dependent on bacterial colonization, but it remains unclear whether a particular microbiota or specific pathogens are involved. We hypothesized that gut colonization differs between preterm and term neonates and that overgrowth of Clostridium perfringens predisposes to NEC. By using terminal-RFLP and FISH, we characterized the gut microbiota of preterm, caesarean-delivered, formula-fed pigs (n = 44) with or without NEC and of formula- or colostrum-fed term, and vaginally born pigs (n = 13). A different microbiota with high C. perfringens abundance was observed in preterm pigs with NEC compared with healthy individuals. However, immunization against C. perfringens toxins did not prevent NEC, and C. perfringens inoculation (3.6 × 10 cfu/d) failed to induce NEC (n = 16), whereas prophylactic broad-spectrum antibiotics treatment prevented NEC (n = 24). Colonization in both groups of term pigs differed from preterm pigs and was dominated by Lactobacilli spp. In conclusion, gestational age (GA) and NEC influence neonatal gut colonization, whereas diet has minor effects. C. perfringens is more abundant in pigs with NEC but rather as a consequence than a cause of disease. The general bacterial load and underdeveloped gut immune responses in preterm neonates seem more important for NEC development than specific pathogens.
早产儿坏死性小肠结肠炎（NEC）依赖于细菌定植，但目前尚不清楚是否存在特定的微生物群或特定的病原体。我们假设，早产儿和足月儿的肠道定植情况不同，并且产气荚膜梭菌过度生长会导致 NEC。我们通过末端-RFLP 和 FISH 技术，对接受配方奶喂养的、有或没有 NEC 的、剖宫产的早产儿（n=44）和接受配方奶或初乳喂养的、经阴道分娩的足月儿（n=13）的肠道微生物群进行了特征描述。与健康个体相比，患有 NEC 的早产儿肠道内存在一种不同的、具有高产气荚膜梭菌丰度的微生物群。然而，针对产气荚膜梭菌毒素的免疫接种并不能预防 NEC，且产气荚膜梭菌接种（3.6×10 cfu/d）未能诱导 NEC（n=16），而预防性广谱抗生素治疗可预防 NEC（n=24）。两组足月儿的定植情况与早产儿不同，以乳杆菌属为主。总之，胎龄（GA）和 NEC 影响新生儿肠道定植，而饮食的影响较小。产气荚膜梭菌在患有 NEC 的猪中更为丰富，但更多的是疾病的结果而不是原因。与特定病原体相比，早产儿中一般细菌负荷和发育不良的肠道免疫反应似乎对 NEC 的发展更为重要。
