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Intestinal dysbiosis in preterm infants preceding necrotizing enterocolitis: a systematic review and meta-analysis
Baylor Coll Med, Dept Pediat, Sect Neonatol, Houston, TX 77030 USA.;Texas Childrens Hosp, Houston, TX 77030 USA..
Baylor Coll Med, Alkek Ctr Metagen & Microbiome Res, Houston, TX 77030 USA..
Washington Univ, Dept Pediat, St Louis Sch Med, St Louis, MO 63130 USA..
Washington Univ, Dept Pediat, St Louis Sch Med, St Louis, MO 63130 USA..
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2017 (English)In: Microbiome, ISSN 0026-2633, E-ISSN 2049-2618, Vol. 5, article id 31Article, review/survey (Refereed) Published
Abstract [en]

Background: Necrotizing enterocolitis (NEC) is a catastrophic disease of preterm infants, and microbial dysbiosis has been implicated in its pathogenesis. Studies evaluating the microbiome in NEC and preterm infants lack power and have reported inconsistent results. Methods and results: Our objectives were to perform a systematic review and meta-analyses of stool microbiome profiles in preterm infants to discern and describe microbial dysbiosis prior to the onset of NEC and to explore heterogeneity among studies. We searched MEDLINE, PubMed, CINAHL, and conference abstracts from the proceedings of Pediatric Academic Societies and reference lists of relevant identified articles in April 2016. Studies comparing the intestinal microbiome in preterm infants who developed NEC to those of controls, using cultureindependent molecular techniques and reported a and beta-diversity metrics, and microbial profiles were included. In addition, 16S ribosomal ribonucleic acid (rRNA) sequence data with clinical meta-data were requested from the authors of included studies or searched in public data repositories. We reprocessed the 16S rRNA sequence data through a uniform analysis pipeline, which were then synthesized by meta-analysis. We included 14 studies in this review, and data from eight studies were available for quantitative synthesis (106 NEC cases, 278 controls, 2944 samples). The age of NEC onset was at a mean +/- SD of 30.1 +/- 2.4 weeks post-conception (n = 61). Fecal microbiome from preterm infants with NEC had increased relative abundances of Proteobacteria and decreased relative abundances of Firmicutes and Bacteroidetes prior to NEC onset. Alpha-or beta-diversity indices in preterm infants with NEC were not consistently different from controls, but we found differences in taxonomic profiles related to antibiotic exposure, formula feeding, and mode of delivery. Exploring heterogeneity revealed differences in microbial profiles by study and the target region of the 16S rRNA gene (V1-V3 or V3-V5). Conclusions: Microbial dysbiosis preceding NEC in preterm infants is characterized by increased relative abundances of Proteobacteria and decreased relative abundances of Firmicutes and Bacteroidetes. Microbiome optimization may provide a novel strategy for preventing NEC.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD , 2017. Vol. 5, article id 31
Keywords [en]
Microbiome, Intestinal, Preterm, Neonate, NEC, 16S rRNA sequencing
National Category
Pediatrics Microbiology in the medical area
Identifiers
URN: urn:nbn:se:uu:diva-320962DOI: 10.1186/s40168-017-0248-8ISI: 000397308600001PubMedID: 28274256OAI: oai:DiVA.org:uu-320962DiVA, id: diva2:1091795
Funder
NIH (National Institute of Health), UH3AI083265 R01 HD059140Available from: 2017-04-28 Created: 2017-04-28 Last updated: 2018-01-13Bibliographically approved

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