Microbes and the Inflammatory Response in Necrotising Enterocolitis

Brooks, Heather J. L.; McConnell, Michelle; Broadbent, Roland

doi:10.5772/55039

Cited by 3 publications

(5 citation statements)

References 176 publications

(249 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…19 It has been postulated that infants who have lower gestation ages take longer to start oral feeding and attain full feeds, hence bacterial colonisation and cytokine priming of the gut is delayed. 20 However, a recent study in the United Kingdom showed a trend towards early-onset NEC in one-third of the VLBW neonates. 21 Similarly, in Indonesia, Kaban et al 22 showed slow advancement of feeds had no protective effect against NEC, but did not comment on timing.…”

Section: Discussionmentioning

confidence: 96%

“…The epidemiology of NEC is such that the age of onset is inversely proportional to gestational age 19 . It has been postulated that infants who have lower gestation ages take longer to start oral feeding and attain full feeds, hence bacterial colonisation and cytokine priming of the gut is delayed 20 . However, a recent study in the United Kingdom showed a trend towards early‐onset NEC in one‐third of the VLBW neonates 21 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Necrotising enterocolitis in a middle‐income country: Early onset and risk factors for mortality

Assenga,

Tooke

2024

Acta Paediatrica

View full text Add to dashboard Cite

AimThere is limited literature available about necrotising enterocolitis (NEC) in low‐ and middle‐income countries. This study sought to determine the proportion, pattern and risk factors for mortality among very low birth weight (VLBW) neonates with NEC in a middle‐income setting.MethodsA retrospective observational cohort study was conducted on all infants with birth weights less than 1501 g admitted from 2018 to 2020 at Groote Schuur Hospital, Cape Town, South Africa. Data were obtained from the Vermont Oxford Network and hospital folders.ResultsA total of 104/1582 (6.6%) neonates were diagnosed with NEC with a median onset of 8 days of life. The mortality rate was 39.0%, compared to the all‐cause mortality rate of 18.7% for VLBW neonates. Thirty‐two (32.0%) neonates with NEC were transferred for surgery of whom 10 (31.3%) died. Small for gestational age (p = 0.13), NEC stage 2B or above (p = 0,002), a positive blood culture (p = 0.018), a raised C‐reactive protein (p = 0.013), hyponatraemia (p = 0.004), anaemia requiring blood transfusion (p = 0.003) and thrombocytopenia requiring platelet transfusion (p = 0.033) were associated with mortality. A positive blood culture was found in 37.0% with a predominance of Klebsiella pneumoniae isolates.ConclusionNEC has an early onset and a high mortality rate in our setting.

show abstract

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Necrotising enterocolitis in a middle‐income country: Early onset and risk factors for mortality

Assenga,

Tooke

2024

Acta Paediatrica

View full text Add to dashboard Cite

show abstract

“…Acidic end product during metabolism of Lactobaccilus and Bifidobacterium lower the pH of gut and is unsuitable for pathogenic growth [11]. The probiotic Bifidobacterium bifidum decreases epithelial cell death by up-regulating TLR2 [10]. Immunological effects differ according to probiotic strain and also bacteria of same species [4].…”

Section: Role Of Probiotics In Decreasing the Severity Of Nec-mentioning

confidence: 99%

“…Bifidobacterium and Lactobacillus are the principal kinds of commensal bacteria found in breast fed babies [2,9]. In formula-fed infants potentially harmful bacterial colonization such as Coliforms, Enterococci, Clostrium and Bacteroids predominate [6,10]. The compromised gut microbiome of preterm due to broad-spectrum antibiotics and NICU environment become more pathogenic due to immature intestinal epithelial barrier and immunity [8].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Necrotizing Enterocolitis: Probiotics, Prebiotics and Synbiotics for Prevention in Preterm Infants

Tripathy¹,

Nanda

Aiims³

2016

Int J Pediatr Res

View full text Add to dashboard Cite

Necrotizing enterocolitis is a devastating disease of newborns associated with intestinal inflammation and necrosis. In spite of advances in neonatal care, intensive care units and refinement of surgical practices, the high mortality and long term morbidity due to NEC remains a challenge. The pathogenesis of the disease is complicated and not completely understood. Gradual development in the field of NEC revealed innate immune system, comprised of 'Toll-like receptors' (TLR) in the pathogenesis of the disease. TLR4 is an important member of TLR and is the receptor for bacterial lipopolysaccharide. Activation of TLR4 causes intestinal mucosal injury and decreased epithelial repair in premature neonates. Probiotics are live microorganisms and are rich in bacterial DNA. CpG motifs of DNA can inhibit TLR4 signaling and reduce NEC severity. Probiotics also modulate enterocyte genes that regulate innate immune-mediated inflammation, thereby preventing NEC. The above molecular basis is supported by multiple individual studies using probiotics especially Lactobacillus and Bifidobacteria for preventing NEC in preterm infants. Their encouraging results prompted us to carry out an analysis of major trials on probiotics along with considering pathophysiological and immunological aspects of the disease. Prebiotics have a protective effect in NEC by stimulating colonization of beneficial bacteria in intestine. Products containing both probiotics and prebiotics (synbiotics) were also tried and they are found to be more beneficial than either probiotics or prebiotics. This review will highlight recent concepts and evidences on probiotics and prebiotics in preventing NEC in preterm, low birth weight infants.

show abstract

Necrotising Enterocolitis in Preterm Infants: Epidemiology and Antibiotic Consumption in the Polish Neonatology Network Neonatal Intensive Care Units in 2009

et al. 2014

View full text Add to dashboard Cite

The aim of this study was to describe the epidemiology of necrotising enterocolitis (NEC), antibiotic consumption and the usefulness of microbiological tests in very low birth weight (VLBW) Polish newborns.MethodsProspective surveillance was performed in the year 2009 by local infection control teams. The study covered 910 infants hospitalized in six Polish neonatal intensive care units. Two kinds of indicators were used for the description of antibiotic usage: the duration of treatment (days of treatment, DOTs) and the defined daily dose (DDD).ResultsNEC incidence was 8.7% and fatality rate was 19%. Chorioamnionitis, late gestational age and low birth weight were identified as risk factors for NEC. Catheterization, mechanical ventilation and other selected procedures were used considerably longer in newborns with NEC than in the remaining neonates. Total usage of antibiotics reached 2.9 DDDs or 1.437 days; the average use of drugs per case of NEC amounted to 0.47 DDD or 23.2 DOTs. The level of antibiotic usage was analysed with correlation to microbiological tests performed and it was non-significantly greater in the group of children with NEC in whom the tests were performed.ConclusionsA high risk of developing NEC is closely associated with VLBW and with inflammation of the amnion during labour. We observed no relationship between the consumption of antibiotics in neonates with NEC and positive results of microbiological testing indicating sepsis accompanying NEC or gut colonization with pathogens.

show abstract

Microbes and the Inflammatory Response in Necrotising Enterocolitis

Cited by 3 publications

References 176 publications

Necrotising enterocolitis in a middle‐income country: Early onset and risk factors for mortality

Necrotising enterocolitis in a middle‐income country: Early onset and risk factors for mortality

Necrotizing Enterocolitis: Probiotics, Prebiotics and Synbiotics for Prevention in Preterm Infants

Necrotising Enterocolitis in Preterm Infants: Epidemiology and Antibiotic Consumption in the Polish Neonatology Network Neonatal Intensive Care Units in 2009

Contact Info

Product

Resources

About