Intestinal microbiota and its relationship with necrotizing enterocolitis

Abstract

Necrotizing enterocolitis (NEC) is a leading cause of morbidity and mortality in infants born prematurely. After birth, the neonatal gut must acquire a healthy complement of commensal bacteria. Disruption or delay of this critical process, leading to deficient or abnormal microbial colonization of the gut, has been implicated as key risk factor in the pathogenesis of NEC. Conversely, a beneficial complement of commensal intestinal microbiota may protect the immature gut from inflammation and injury. Interventions aimed at providing or restoring a healthy complement of commensal bacteria, such as probiotic therapy, are currently the most promising treatment to prevent NEC. Shifting the balance of intestinal microbiota from a pathogenic to protective complement of bacteria can protect the gut from inflammation and subsequent injury that leads to NEC. Herein, we review the relationship of intestinal microbiota and NEC in preterm infants.

Figure 1. Risk factors for NEC

Figure depicts the multiple risk factors that influence the development of NEC in premature infants. Abbreviations: NEC, necrotizing enterocolitis; RBC, red blood cell.

Figure 2. Factors disrupting the acquisition of commensal microbiota

Multiple factors promote abnormal gut colonization in preterm infants by delaying or disrupting the acquisition of beneficial commensal bacterial from the infant’s mother and external environment.