Department of Neonatology, HELIOS Children's Hospital, 42283 Wuppertal, Witten/Herdecke University, Germany.
Biomed Res Int. 2013;2013:150372. doi: 10.1155/2013/150372. Epub 2013 Nov 6.
To describe the development of the gut microbiota in extremely low birth weight (ELBW) infants with and without necrotizing enterocolitis (NEC) between April 2008 and December 2009, fecal microflora was prospectively analyzed in fecal samples of all ELBW infants using real-time PCR assays. In addition, fecal inflammatory were measured.
Fecal microflora established early in ELBW infants and microbiota composition remained stable over the first 28 days of life except for the prevalence of C. difficile which decreased with decreasing antibiotic use. Infants who subsequently developed NEC had an increase of total bacterial count (9.8-fold) 24 h prior to clinical symptoms mainly due to the expansion of E. coli species (21.6-fold), whereas microbiota composition did not differ from healthy ELBW infants five days before onset of NEC. Importantly, S100A12 and hBD2 positively correlated with the total and E. coli bacterial CFU/g feces (r (2) 0.4 and 0.64, resp.).
In summary, we found evidence for a disturbed homeostasis between the intestinal microbiome and host immunity in ELBW infants with NEC. Moreover, S100A12 and hBD2 correlate with the fecal microbiota thus linking the intestinal innate immune response to the bacterial colonization thus possibly providing a diagnostic tool in the future.
描述极低出生体重（ELBW）儿肠道微生物群的发展，2008 年 4 月至 2009 年 12 月，采用实时 PCR 法对所有 ELBW 儿的粪便样本进行前瞻性分析，描述无坏死性小肠结肠炎（NEC）和有 NEC 的 ELBW 儿粪便微生物群的变化。此外，还测量了粪便炎症标志物。
ELBW 儿的粪便微生物群在早期建立，微生物群组成在生命的头 28 天保持稳定，除艰难梭菌的流行率随抗生素使用减少而降低外。随后发生 NEC 的儿在出现临床症状前 24 小时总细菌计数增加（9.8 倍），主要是由于大肠杆菌种的扩张（21.6 倍），而微生物群组成与 NEC 发病前 5 天的健康 ELBW 儿无差异。重要的是，S100A12 和 hBD2 与总细菌和大肠杆菌 CFU/g 粪便呈正相关（r (2) 分别为 0.4 和 0.64）。
总之，我们发现 NEC 的 ELBW 儿的肠道微生物群和宿主免疫之间存在失衡的证据。此外，S100A12 和 hBD2 与粪便微生物群相关，将肠道固有免疫反应与细菌定植联系起来，因此可能为未来提供一种诊断工具。
