Department of Surgery, University of Chicago, Chicago, Illinois, USA.
Curr Opin Pediatr. 2013 Jun;25(3):382-7. doi: 10.1097/MOP.0b013e3283600e91.
Necrotizing enterocolitis (NEC) continues to be a major cause of morbidity and mortality in low birth weight infants. Although decades of research point to a role for gut bacteria in the pathogenesis of the disease, the exact relationship between microbes and NEC has not been elucidated. In this review, we describe recent advances in the use of molecular methods to compare gut bacteria in infants with and without NEC.
Our understanding of how bacteria contribute to NEC pathogenesis has been limited by the use of traditional, culture-based investigations. Recent advances in microbial ecology and DNA sequencing have made it possible to comprehensively study gut bacterial populations and to understand their physiologic importance. Several studies have identified differences in the microbiota among infants with and without NEC, but the findings have often varied across studies.
To date, no single change in the gut microbiota has definitively been identified as a risk factor or cause of NEC. The findings at present suggest that NEC does not result from growth of a single causative pathogen, but rather that the disease results from a generalized disturbance of normal colonization patterns in the developing gut.
坏死性小肠结肠炎（NEC）仍然是低出生体重儿发病率和死亡率的主要原因。尽管几十年来的研究表明肠道细菌在疾病发病机制中起作用，但微生物与 NEC 的确切关系尚未阐明。在这篇综述中，我们描述了最近使用分子方法来比较有无 NEC 的婴儿肠道细菌的研究进展。
我们对细菌如何促进 NEC 发病机制的理解受到传统培养为基础的调查方法的限制。微生物生态学和 DNA 测序的最新进展使得全面研究肠道细菌群和理解其生理重要性成为可能。有几项研究已经确定了有无 NEC 的婴儿之间的微生物群落的差异，但这些发现往往因研究而异。
迄今为止，尚未确定肠道微生物群中的任何单一变化是 NEC 的危险因素或病因。目前的研究结果表明，NEC 不是由单一病原体的生长引起的，而是由于发育中肠道正常定植模式的普遍紊乱所致。
