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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Microbiome
2017 ; 5
(1
): 31
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Intestinal dysbiosis in preterm infants preceding necrotizing enterocolitis: a
systematic review and meta-analysis
#MMPMID28274256
Pammi M
; Cope J
; Tarr PI
; Warner BB
; Morrow AL
; Mai V
; Gregory KE
; Kroll JS
; McMurtry V
; Ferris MJ
; Engstrand L
; Lilja HE
; Hollister EB
; Versalovic J
; Neu J
Microbiome
2017[Mar]; 5
(1
): 31
PMID28274256
show ga
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 culture-independent molecular techniques and reported ? and
?-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.