title: Multiple Opportunistic Pathogens, but Not Pre-existing Inflammation, May Be Associated with Necrotizing Enterocolitis.
abstract: BACKGROUND
  Necrotizing enterocolitis (NEC) leads to significant morbidity and mortality in the neonatal intensive care unit. Although current evidence would suggest that bacteria contribute to the pathogenesis of NEC, no single bacterium has yet been identified.
  
  
  OBJECTIVE
  The aims of this study were to investigate fecal S100A12 concentrations and the intestinal bacterial community in premature infants (24-32 weeks) and investigate any associations between the microbiota and the development of NEC.
  
  
  METHODS
  Meconium and feces were collected from premature newborn infants (between 24 and 32 weeks gestation) over the first 4 weeks of life. Fecal S100A12 concentrations were assayed by immunoassay, and samples were subject to 16S rDNA analysis using next-generation sequencing techniques.
  
  
  RESULTS
  Fecal samples were collected from four infants that developed NEC and 18 control infants. Prior to developing NEC, fecal S100A12 concentrations were not elevated; however, following NEC diagnosis, concentrations were highly elevated. The fecal bacterial communities of infants with NEC did not differ significantly from control infants. However, potentially pathogenic bacteria were detected in significantly more infants with NEC than in controls (p = 0.0007).
  
  
  CONCLUSIONS
  At birth, fecal S100A12 concentrations were not elevated in premature infants subsequently developing NEC in this cohort. Following NEC diagnosis, S100A12 concentrations were highly elevated, suggesting that this potentially could act as a marker of disease progression. Higher detection rates of potentially pathogenic bacteria in NEC infants suggest that a range of potentially pathogenic bacteria may collectively contribute to NEC pathogenesis.
authors.affiliation: School of Women's and Children's Health, University of New South Wales, High Street, Sydney, NSW, 2031, Australia. s.leach@unsw.edu.au.
authors.forename: Steven T
authors.initials: ST
authors.lastname: Leach
authors.affiliation: School of Women's and Children's Health, University of New South Wales, High Street, Sydney, NSW, 2031, Australia.|Department of Newborn Care, Royal Hospital for Women, Sydney, Australia.
authors.forename: Kei
authors.initials: K
authors.lastname: Lui
authors.affiliation: Virology, Department of Microbiology, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, Australia.
authors.forename: Zin
authors.initials: Z
authors.lastname: Naing
authors.affiliation: Molecular Research LP, MR DNA, Shallowater, TX, USA.
authors.forename: Scot E
authors.initials: SE
authors.lastname: Dowd
authors.affiliation: School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, Australia.
authors.forename: Hazel M
authors.initials: HM
authors.lastname: Mitchell
authors.affiliation: School of Women's and Children's Health, University of New South Wales, High Street, Sydney, NSW, 2031, Australia.|Department of Paediatrics, University of Otago, Christchurch, New Zealand.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Day
mesh_terms: D001419:Bacteria / Q000145:classification* / Q000302:isolation & purification; D016022:Case-Control Studies; D020345:Enterocolitis, Necrotizing / Q000382:microbiology* / Q000473:pathology*; D005243:Feces / Q000737:chemistry / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007249:Inflammation / Q000378:metabolism*; D008297:Male; D008470:Meconium / Q000737:chemistry / Q000382:microbiology; D009894:Opportunistic Infections / Q000382:microbiology*; D000067616:S100A12 Protein / Q000032:analysis / Q000235:genetics / Q000378:metabolism
chemical_list: D000067616:S100A12 Protein; C090441:S100A12 protein, human
keywords: Intestinal inflammation; Necrotizing enterocolitis; Opportunistic pathogenic bacteria; S100A12