Imperial College London
Alternate

DrKathleenSim

Faculty of Medicine, Department of Infectious Disease

Honorary Clinical Research Fellow
 
 
 
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Contact

 

+44 (0)20 7594 3717k.sim

 
 
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Location

 

125Wright Fleming WingSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Sim:2015:cid/ciu822,
author = {Sim, K and Shaw, AG and Randell, P and Cox, MJ and McClure, ZE and Li, M-S and Haddad, M and Langford, PR and Cookson, WOCM and Moffatt, MF and Kroll, JS},
doi = {cid/ciu822},
journal = {Clinical Infectious Diseases},
pages = {389--397},
title = {Dysbiosis anticipating necrotizing enterocolitis in very premature infants},
url = {http://dx.doi.org/10.1093/cid/ciu822},
volume = {60},
year = {2015}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background. Necrotizing enterocolitis (NEC) is a devastating inflammatory bowel disease of premature infants speculatively associated with infection. Suspected NEC can be indistinguishable from sepsis, and in established cases an infant may die within hours of diagnosis. Present treatment is supportive. A means of presymptomatic diagnosis is urgently needed. We aimed to identify microbial signatures in the gastrointestinal microbiota preceding NEC diagnosis in premature infants.Methods. Fecal samples and clinical data were collected from a 2-year cohort of 369 premature neonates. Next-generation sequencing of 16S ribosomal RNA gene regions was used to characterize the microbiota of prediagnosis fecal samples from 12 neonates with NEC, 8 with suspected NEC, and 44 controls. Logistic regression was used to determine clinical characteristics and operational taxonomic units (OTUs) discriminating cases from controls. Samples were cultured and isolates identified using matrix-assisted laser desorption/ionization–time of flight. Clostridial isolates were typed and toxin genes detected.Results. A clostridial OTU was overabundant in prediagnosis samples from infants with established NEC (P = .006). Culture confirmed the presence of Clostridium perfringens type A. Fluorescent amplified fragment-length polymorphism typing established that no isolates were identical. Prediagnosis samples from NEC infants not carrying profuse C. perfringens revealed an overabundance of a Klebsiella OTU (P = .049). Prolonged continuous positive airway pressure (CPAP) therapy with supplemental oxygen was also associated with increased NEC risk.Conclusions. Two fecal microbiota signatures (Clostridium and Klebsiella OTUs) and need for prolonged CPAP oxygen signal increased risk of NEC in presymptomatic infants. These biomarkers will assist development of a screening tool to allow very early diagnosis of NEC.Clinical Trials Registration. NCT01102738.
AU  - Sim,K
AU  - Shaw,AG
AU  - Randell,P
AU  - Cox,MJ
AU  - McClure,ZE
AU  - Li,M-S
AU  - Haddad,M
AU  - Langford,PR
AU  - Cookson,WOCM
AU  - Moffatt,MF
AU  - Kroll,JS
DO  - cid/ciu822
EP  - 397
PY  - 2015///
SN  - 1537-6591
SP  - 389
TI  - Dysbiosis anticipating necrotizing enterocolitis in very premature infants
T2  - Clinical Infectious Diseases
UR  - http://dx.doi.org/10.1093/cid/ciu822
UR  - https://academic.oup.com/cid/article/60/3/389/312058
UR  - http://hdl.handle.net/10044/1/23207
VL  - 60
ER  -
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