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Early intestinal colonization phenotypes predict necrotizing enterocolitis in preterm infants
Author(s) -
Morrow Ardythe L,
Lagomarcino Anne J,
Schibler Kurt R,
Taft Diana H,
Yu Zhuoteng,
Wang Bo,
Gevers Dirk,
Ward Doyle V,
Kennedy Michael A,
Huttenhower Curtis,
Newburg David S
Publication year - 2013
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.27.1_supplement.357.1
Subject(s) - necrotizing enterocolitis , dysbiosis , firmicutes , medicine , gastroenterology , microbiome , gestational age , enterocolitis , physiology , biology , disease , bioinformatics , 16s ribosomal rna , bacteria , genetics , pregnancy
Necrotizing enterocolitis (NEC) afflicts 10% of extremely preterm infants. The contribution of early intestinal colonization to subsequent NEC onset is not understood. We analyzed prospectively banked samples collected prior to disease onset from infants <29 wks gestational age, including 11 who developed NEC and 21 matched controls who survived free of NEC. Stool bacterial communities were profiled by 16S rRNA gene sequencing. Two forms of dysbiosis preceded NEC. During postnatal days 4 to 9, the samples from 4 NEC cases were dominated by phylum Firmicutes (relative abundance: >;99% vs <15% in the remaining NEC and controls, p<0.001). During days 10 to 16, samples from the remaining NEC cases were dominated by phylum Proteobacteria (relative abundance >;99% vs 39% in the other NEC cases and 84% in controls, p=0.01). NEC preceded by Firmicutes dysbiosis occurred during postnatal days 7 to 21, whereas NEC preceded by Proteobacteria dysbiosis occurred later, days 19 to 39. Metabolomic analysis of urine samples from days 4 to 9 identified metabolites that predicted onset of one the two microbially‐defined NEC types vs controls (p<0.01), but no metabolites differed between all NEC cases and controls. Distinct forms of dysbiosis may help predict NEC well in advance of onset, providing clues to the underlying pathobiology. Project funded by NIH HD 05491, NIH T32 ES 010957–12, and NIAID NIH HHS Contract No. HHSN272200900018C