Molecular Testing for Gastrointestinal Pathogens in Intestinal Tissue of Infants with Necrotizing Enterocolitis or Spontaneous Intestinal Perforation

Overview

Journal J Perinatol

Specialty Gynecology & Obstetrics

Date 2024 Jun 7

PMID 38849546

Authors

Maria M Talavera-Barber

Pablo J Sanchez

Miriam Conces

Irina Kaptsan

Kathy Everhart

Amy Leber

Daniel T Malleske

Mohannad Moallem

Santiago Panesso-Gomez

Masako Shimamura

Affiliations

Soon will be listed here.

Abstract

Objective: The objective of this study was to determine the frequency of common gastrointestinal bacterial, parasitic, and viral pathogen detection in necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP) -associated intestinal tissue.

Study Design: Retrospective cohort study examined formalin fixed, paraffin embedded (FFPE) surgical or autopsy intestinal tissue from NEC or SIP specimens. DNA and RNA were extracted and analyzed by multiplex PCR panel (GIFA Biofire). DNA or RNA from stool samples containing each pathogen were extracted for positive controls.

Results: The total number of intestinal tissue samples were 193 from 310 infants (156 NEC, 37 SIP). Six (3%) infants with stage III NEC tested positive for a target pathogen; 2, C. difficile; 3, Enteroaggregtive E. coli; and 1, Giardia. No gastrointestinal viral pathogens were detected.

Conclusion: Molecular testing yielded few GI pathogens suggesting that these organisms are likely not major causes or facilitators of NEC or SIP.

References

Motta C, Scott W, Mahony L, Koch J, Wyckoff M, Reisch J . The association of congenital heart disease with necrotizing enterocolitis in preterm infants: a birth cohort study. J Perinatol. 2015; 35(11):949-53. DOI: 10.1038/jp.2015.96. View

Zhang J, Guan H, Zhao W, Zhang H, Wang W, Ling X . Evaluation of the BioFire FilmArray Gastrointestinal Panel and Real-Time Polymerase Chain Reaction Assays for the Detection of Major Diarrheagenic Pathogens by a Multicenter Diarrheal Disease Surveillance Program in China. Foodborne Pathog Dis. 2019; 16(11):788-798. DOI: 10.1089/fpd.2019.2642. View

Roy S, Meng Q, Sadowitz B, Kollisch-Singule M, Yepuri N, Satalin J . Enteral administration of bacteria fermented formula in newborn piglets: A high fidelity model for necrotizing enterocolitis (NEC). PLoS One. 2018; 13(7):e0201172. PMC: 6056052. DOI: 10.1371/journal.pone.0201172. View

Neu J, Walker W . Necrotizing enterocolitis. N Engl J Med. 2011; 364(3):255-64. PMC: 3628622. DOI: 10.1056/NEJMra1005408. View

Huda S, Chaudhery S, Ibrahim H, Pramanik A . Neonatal necrotizing enterocolitis: Clinical challenges, pathophysiology and management. Pathophysiology. 2014; 21(1):3-12. DOI: 10.1016/j.pathophys.2013.11.009. View

Lin P, Nasr T, Stoll B . Necrotizing enterocolitis: recent scientific advances in pathophysiology and prevention. Semin Perinatol. 2008; 32(2):70-82. DOI: 10.1053/j.semperi.2008.01.004. View

Cushing A . Necrotizing enterocolitis with Escherichia coli heat-labile enterotoxin. Pediatrics. 1983; 71(4):626-30. View

George S, Aguilera X, Gallardo P, Farfan M, Lucero Y, Torres J . Bacterial Gut Microbiota and Infections During Early Childhood. Front Microbiol. 2022; 12:793050. PMC: 8767011. DOI: 10.3389/fmicb.2021.793050. View

Pumberger W, Novak W . Fatal neonatal Salmonella enteritidis sepsis. J Perinatol. 2000; 20(1):54-6. DOI: 10.1038/sj.jp.7200298. View

10.

Cichocki M, Singer G, Beyerlein S, Zeder S, Schober P, Hollwarth M . A case of necrotizing enterocolitis associated with adenovirus infection in a term infant with 22q11 deletion syndrome. J Pediatr Surg. 2008; 43(4):e5-8. DOI: 10.1016/j.jpedsurg.2007.11.034. View

11.

Mani S, Hazra S, Hagan J, Sisson A, Nair J, Pammi M . Viral Infections and Neonatal Necrotizing Enterocolitis: A Meta-analysis. Pediatrics. 2023; 152(1). DOI: 10.1542/peds.2022-060876. View

12.

Ullrich T, Tang Y, Correa H, Garzon S, Maheshwari A, Hill M . Absence of gastrointestinal pathogens in ileum tissue resected for necrotizing enterocolitis. Pediatr Infect Dis J. 2011; 31(4):413-4. PMC: 3305842. DOI: 10.1097/INF.0b013e318242534a. View

13.

Smith B, Bode S, Petersen B, Jensen T, Pipper C, Kloppenborg J . Community analysis of bacteria colonizing intestinal tissue of neonates with necrotizing enterocolitis. BMC Microbiol. 2011; 11:73. PMC: 3094198. DOI: 10.1186/1471-2180-11-73. View

14.

Dittmar E, Beyer P, Fischer D, Schafer V, Schoepe H, Bauer K . Necrotizing enterocolitis of the neonate with Clostridium perfringens: diagnosis, clinical course, and role of alpha toxin. Eur J Pediatr. 2007; 167(8):891-5. DOI: 10.1007/s00431-007-0614-9. View

15.

Beatty J, Akierman S, Motta J, Muise S, Workentine M, Harrison J . Giardia duodenalis induces pathogenic dysbiosis of human intestinal microbiota biofilms. Int J Parasitol. 2017; 47(6):311-326. DOI: 10.1016/j.ijpara.2016.11.010. View

16.

Coggins S, Wynn J, Weitkamp J . Infectious causes of necrotizing enterocolitis. Clin Perinatol. 2015; 42(1):133-54, ix. PMC: 4328138. DOI: 10.1016/j.clp.2014.10.012. View

17.

Meinzen-Derr J, Morrow A, Hornung R, Donovan E, Dietrich K, Succop P . Epidemiology of necrotizing enterocolitis temporal clustering in two neonatology practices. J Pediatr. 2008; 154(5):656-61. PMC: 2700364. DOI: 10.1016/j.jpeds.2008.11.002. View

18.

Patel R, Denning P . Intestinal microbiota and its relationship with necrotizing enterocolitis. Pediatr Res. 2015; 78(3):232-8. PMC: 4655440. DOI: 10.1038/pr.2015.97. View

19.

Thomas D, Bell B, Papillon S, Delaplain P, Lim J, Golden J . Colonization with Escherichia coli EC 25 protects neonatal rats from necrotizing enterocolitis. PLoS One. 2017; 12(11):e0188211. PMC: 5708813. DOI: 10.1371/journal.pone.0188211. View

20.

Vongbhavit K, Underwood M . Intestinal perforation in the premature infant. J Neonatal Perinatal Med. 2017; 10(3):281-289. DOI: 10.3233/NPM-16148. View