Fetal and preterm infant microbiomes: a new perspective of necrotizing enterocolitis

Abstract

Necrotizing enterocolitis (NEC) is a devastating condition of hospitalized preterm infants. Numerous studies have attempted to identify the cause of NEC by examining the immunological features associated with pathogenic microorganisms. No single organism has proven responsible for the disease; however, immunological studies are now focused on the microbiome. Recent research has investigated the numerous bacterial species residing in the body and their role in diseases in preterm infants. The timing of initial microbial colonization is a subject of interest. The microbiome appears to transfer from the mother to the newborn, as well as to the fetus. Cross-talk between the fetus and fetal microbiome takes place continuously to generate a unique immune system. This review examined the transfer of the microbiome to the human fetus, and its potential relationship with NEC.

Early Use of Antibiotics Is Associated with a Lower Incidence of Necrotizing Enterocolitis in Preterm, Very Low Birth Weight Infants: The NEOMUNE-NeoNutriNet Cohort Study

“…[8] Early antibiotic treatment may delay the rapid colonization after birth in the immature preterm intestine. [28][29][30] A brief delay may provide time for intestinal postnatal adaptation of immune defense mechanisms, such as mucosal barrier function which undergoes significant maturation within the first few days after birth in preterm infants, [31] as also supported by studies in preterm pigs. [6,32] Prolonged duration of antibiotic treatment, starting in the early neonatal period, has been linked to higher incidence of NEC as well as disruption of the intestinal microbial composition.…”

Early antibiotic use and incidence of necrotising enterocolitis in very preterm infants: a protocol for a UK based observational study using routinely recorded data

“…Early bacterial nature and load in the preterm gut have been linked to NEC development. 18 19 Use of intravenous antibiotics shortly after birth may slow colonisation, allowing the gut immune system a short period of adaption that reduces the risk of TLR4 mediated NEC. 20 The integrity of the mucosal barrier has been shown to improve significantly in the first days after preterm birth in humans.…”

“…Data are currently conflicting as to the overall impact on NEC of receiving (or withholding) antibiotics in the first days of life. Early bacterial nature and load in the preterm gut have been linked to NEC development 18 19. Use of intravenous antibiotics shortly after birth may slow colonisation, allowing the gut immune system a short period of adaption that reduces the risk of TLR4 mediated NEC 20.…”

Ultrasound Diagnosis of Necrotizing Enterocolitis

“…Микробиом -совокупность всех микроорганизмов, обитающих в теле человека, вероятно, переходит от матери к новорожденно-му, а также к плоду. Перекрестная связь между плодом и эмбриональным микробиомом происходит непрерывно, для того чтобы сформировать уникальную иммунную систему новорожденного к моменту рождения [12]. Современная гипотеза подчеркивает роль незрелости ЖКТ и иммунной системы у недоношенных новорожденных, приводящей к уязвимости стенки кишечника.…”