Necrotizing Enterocolitis is associated with Ureaplasma Colonization in Preterm Infants
Adora C. Okogbule-Wonodi,George W Gross,Chen-Chih J. Sun,Alexander G Agthe,Li Xiao,Ken B. Waites,Rose M. Viscardi +6 more
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TLDR
Ureaplasma may be a factor in NEC pathogenesis in preterm infants by contributing to intestinal mucosal injury and/or altering systemic or local immune responses.Abstract:
The study objective was to determine whether Ureaplasma respiratory tract colonization of preterm infants <33 wk gestation is associated with an increased risk for necrotizing enterocolitis (NEC). One or more tracheal or nasopharyngeal aspirates for Ureaplasma culture and PCR were obtained during the first week of life from 368 infants <33 wk gestation enrolled from 1999 to 2003 or from 2007 to 2009. NEC Bell stage ≥ 2 was confirmed by radiological criteria, and pathology, if available. Cord serum samples were analyzed for IL-6 and IL-1β concentrations, and placentas were reviewed for histological chorioamnionitis in the first cohort. NEC was confirmed in 29 of 368 (7.9%) of the combined cohorts. The incidence of NEC was 2.2-fold higher in Ureaplasma-positive (12.3%) than Ureaplasma-negative (5.5%) infants <33 wk (OR, 2.43; 95% CI, 1.13-5.2; p = 0.023) and 3.3-fold higher in Ureaplasma-positive (14.6%) than Ureaplasma-negative (4.4%) infants ≤ 28 wk (OR, 3.67; 95% CI, 1.36-9.93; p = 0.01). Age of onset, hematologic parameters at onset, and NEC severity were similar between Ureaplasma-positive and negative infants. Cord serum IL-6 and IL-1β concentrations were significantly higher in Ureaplasma-positive than in Ureaplasma-negative NEC-affected infants. Ureaplasma may be a factor in NEC pathogenesis in preterm infants by contributing to intestinal mucosal injury and/or altering systemic or local immune responses.read more
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The Intestinal Microbiome in Early Life: Health and Disease
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Microbial contact during pregnancy, intestinal colonization and human disease
TL;DR: The current body of knowledge regarding perinatal microbial contact, initial intestinal colonization and its association with human disease, as well as means of modulating early host–microbe interaction to reduce the risk of disease in the child are described.
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Chorioamnionitis as a Risk Factor for Necrotizing Enterocolitis: A Systematic Review and Meta-Analysis
TL;DR: Currently available evidence supports a role for antenatal inflammation in NEC pathophysiology, and the need to further study the underlying mechanisms and evaluate potential interventions to improve postnatal intestinal outcomes is emphasized.
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Maternal influences on fetal microbial colonization and immune development
TL;DR: It is explained how normal gut colonization drives a balanced neonatal mucosal immune system, while dysbiosis contributes to aberrant immune function early in life and beyond.
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Gut microbiota, the immune system, and diet influence the neonatal gut–brain axis
TL;DR: The anatomy and physiology of the gut–brain axis are highlighted and transmission of stress signals caused by immune-microbial dysfunction in the gut are described to suggest that intestinal microbiota can indirectly harm the brain of preterm infants.
References
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Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging
Martin J. Bell,Jessie L. Ternberg,Ralph D. Feigin,James P. Keating,Richard Marshall,Leslie L. Barton,Thomas Brotherton +6 more
TL;DR: These studies support the use of combination antimicrobial therapy in the treatment of infants with NEC and suggest vigorous diagnostic and supportive measures are appropriate for Stage I infants.
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Prolonged duration of initial empirical antibiotic treatment is associated with increased rates of necrotizing enterocolitis and death for extremely low birth weight infants.
C. Michael Cotten,Sarah A. Taylor,Barbara J. Stoll,Ronald N. Goldberg,Nellie I. Hansen,Pablo J. Sánchez,Namasivayam Ambalavanan,Daniel K. Benjamin +7 more
TL;DR: Prolonged initial empirical antibiotic therapy may be associated with increased risk of necrotizing enterocolitis or death and should be used with caution.
Journal ArticleDOI
Neonatal necrotizing enterocolitis
TL;DR: Heroin and Methadone Withdrawal in Newborns . . . A. M. Reddy, R. S. Stern 353 Umbilical Catheterization: Risk of Infections R. L. Cohen, J. P. Wiebe, E. W. Waisman 401 AmpiciUin and Chloramphenicol for H. lnfluenzae, and choice of Medical Care for Preschool Children.
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Mycoplasmas and Ureaplasmas as Neonatal Pathogens
TL;DR: This review summarizes the epidemiology of genital mycoplasmas as causes of neonatal infections and premature birth; evidence linking ureaplasmas with bronchopulmonary dysplasia; recent changes in the taxonomy of the genus Ureaplasma; the neonatal host response to Mycoplasma and urea plasma infections; advances in laboratory detection, including molecular methods; and therapeutic considerations for treatment of systemic diseases.
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Mortality of necrotizing enterocolitis expressed by birth weight categories.
Shimae Fitzgibbons,Yiming Ching,David C. Yu,Joe Carpenter,Michael J. Kenny,Christopher B. Weldon,Craig W. Lillehei,Clarissa Valim,Jeffrey D. Horbar,Tom Jaksic +9 more
TL;DR: The in-hospital mortality rate of neonates with NEC remains high and is significantly related to birth weight category, and the odds ratios indicate that NEC has a relatively greater impact upon mortality at higher birth weight.