Analysis Of The Correlation Between Intestinal Flora And Neonatal Necrotizing Enterocolitis

Objective:Neonatal necrotizing enterocolitis(NEC)is a serious disease in the neonatal period.At present,its pathogenesis is not completely clear.This study discussed the relationship between intestinal flora and NEC by analyzing the composition of fecal flora in premature infants,so as to provide reference for further studies on the pathogenesis,clinical prevention and treatment of NEC.Methods:Stool samples from all premature infants less than 33 weeks of gestational age who met the inclusion criteria were collected in the First Hospital of Jilin University from August 2018 to April 2019.Samples were collected including meconium(within 48 hours after birth),and later once a week until 28 days after birth.Stool samples at the onset of illness and after antibiotic treatment were also collected from premature infants with NEC.Finally,13 preterm infants with NEC and 13 preterm infants without NEC were recruited and samples were divided into NEC and control group.The microbe of stool samples in two groups was analyzed by 16 Sr RNA gene sequencing technology.And the data were statistically analyzed by using Graphpad prsim6.0 software.p<0.05 was considered as a significant statistical difference.Results:(1)In general information: NEC group: the average age of premature infants when NEC happened was(28.2d±6d),average gestational age(29.9w±1.8d),average birth weight(1462g±317g).Control group: average gestational age(30w±2.7d),average birth weight(1417g±305g).There was no significant difference in gestational age,birth weight and delivery modes between the two groups(p>0.05).(2)The alpha diversity indices in meconium and stool samples when NEC occurred in NEC group were higher than that in control group(p<0.05).(3)At the phylum level,the relative abundance of Bacteroidetes in meconium in NEC group was higher than that in control group.At the genus level,the relative abundance of Acinetobacter was higher in NEC group than control group(p<0.05).(4)At the phylum level,the relative abundance of Bacteroidetes was higher when NEC occurred than that of the control group(28 days after birth).At the genus level,the relative abundance of Acinetobacter was higher than control group(p<0.05).(5)The abundance of Klebsiella increased significantly when NEC occurred,and decreased after antibiotic administration(p<0.05).Conclusions:(1)The sustained high level of bacterial diversity and richness of intestinal flora in premature infants after birth is related to the occurrence of NEC.(2)The increased high abundance of Bacteroidetes and Acinetobacter in meconium and sustained high abundance in stool samples of premature infants after birth are related to the occurrence of NEC.(3)The change of the abundance of Klebsiella is consistent with the occurrence and therapeutic outcome of NEC.