Intestinal dysbiosis in preterm infants preceding necrotizing enterocolitis: a systematic review and meta-analysis

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. Our objectives were to perform a systematic r...

Full description

Saved in:

Bibliographic Details
Published in:	Microbiome Vol. 5; no. 1; p. 31
Main Authors:	Pammi, Mohan, Cope, Julia, Tarr, Phillip I, Warner, Barbara B, Morrow, Ardythe L, Mai, Volker, Gregory, Katherine E, Kroll, J Simon, McMurtry, Valerie, Ferris, Michael J, Engstrand, Lars, Lilja, Helene Engstrand, Hollister, Emily B, Versalovic, James, Neu, Josef
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 09-03-2017 BioMed Central
Subjects:	16S rRNA sequencing Age Antibiotics Archives & records Babies Bacteria - isolation & purification Bacteroides - genetics Bacteroides - isolation & purification Complications and side effects Data processing Diversity indices Dysbacteriosis Dysbiosis Enterocolitis Enterocolitis, Necrotizing - microbiology Enterocolitis, Neonatal necrotizing Enterocolitis, Pseudomembranous Fecal microflora Feces - microbiology Firmicutes - genetics Firmicutes - isolation & purification Gastrointestinal diseases Gastrointestinal Microbiome Health aspects Humans Infant, Newborn Infant, Premature Infant, Premature, Diseases Infants Infants (Premature) Intestinal Intestine Intestines - microbiology Intestines - physiopathology Medicin och hälsovetenskap Meta-analysis Microbiome Mortality NEC Necrosis Necrotizing enterocolitis Neonate Newborn babies Pathogenesis Premature babies Preterm Proteobacteria - genetics Proteobacteria - isolation & purification Review Risk factors RNA, Ribosomal, 16S rRNA 16S Studies Taxonomy Neonate NEC 16S rRNA sequencing Intestinal Microbiome Preterm
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	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. 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 culture-independent molecular techniques and reported α and β-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). 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.
Bibliography:	SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Review-1 ObjectType-Article-3 ObjectType-Undefined-4
ISSN:	2049-2618 2049-2618
DOI:	10.1186/s40168-017-0248-8