Multiple instance learning for predicting necrotizing enterocolitis in premature infants using microbiome data

A prospective investigation was conducted to determine if infants with necrotizing enterocolitis had evidence of carbohydrate intolerance prior to the onset of clinical symptoms of advanced disease. Stool specimens were examined for fecal reducing substances with Clintest tablets from well, full-term infants and sick premature infants. Only two of 45 (4.4%) formula-fed, full-term infants demonstrated higher than 2 + fecal reducing substances. Ten of 14 (71%) formula-fed premature infants who developed necrotizing enterocolitis had higher than 2 + reducing substances detected in their stools. Daily measurement of fecal reducing substances can be a useful adjunct in the management of sick premature infants.

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Influence of Family Integrated Care on the Intestinal Microbiome of Preterm Infants With Necrotizing Enterocolitis and Enterostomy: A Preliminary Study

Frontiers in Pediatrics ◽

10.3389/fped.2021.678254 ◽

2021 ◽

Vol 9 ◽

Author(s):

Mengyang Yang ◽

Juan Du ◽

Qin Yang ◽

Wenyan Dou ◽

Min Jiang ◽

...

Keyword(s):

Integrated Care ◽

Preterm Infants ◽

Necrotizing Enterocolitis ◽

Premature Infants ◽

Intestinal Flora ◽

Intestinal Microbiome ◽

Rrna Gene ◽

Α Diversity ◽

Family Integrated Care ◽

Family Integrated

The aim of this study was to investigate the influence of family integrated care (FICare) on the intestinal microbiome of preterm infants with necrotizing enterocolitis and enterostomy. This was a prospective pilot study at Beijing Children's Hospital. Premature infants with an enterostomy who met the enrollment criteria were divided into the 2-week FICare and non-FICare groups (non-randomly). We collected their fecal samples and subjected the intestinal microbiomes to 16S rRNA gene sequencing. Operational taxonomic units (OTU) were analyzed to assess the intestinal microbiome richness, and we then carried out α-diversity, β-diversity, and species clustering analyses and a linear discriminant analysis (LDA) effect size (LEfSe) analysis to identify the differences in the microbial communities between the two groups. There were 12 patients enrolled in the study (FICare, n = 7; non-FICare, n = 5). There were no significant between-group differences in demographic characteristics, or in the relative abundances of phyla and genera. The major bacterial phyla were Proteobacteria, Firmicutes, and Actinobacteria, and Serratia, Enterococcus, Cronobacter, and Bifidobacterium dominated at the genus level. The α-diversity analysis indicated that the intestinal flora was more diverse in the non-FICare group than the FICare group (p < 0.05). However, most of the other indicators did not suggest a difference between the two groups. There was a high proportion of shared OTUs between the two groups, and the PCoA and clustering analyses indicated that the two groups were difficult to distinguish, indicating that the intestinal microbiomes were relatively similar between the groups. In summary, short-term FICare had no significant positive effect on the establishment of intestinal flora diversity in premature infants with necrotizing enterocolitis and enterostomy. The trial was registered in the Chinese Clinical Trial Registry (ChiCTR-OPN-17011801).

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Impacts of Enriched Human Milk Cells on Fecal Metabolome and Gut Microbiome of Premature Infants with Stage I Necrotizing Enterocolitis: A Pilot Study

Molecular Nutrition & Food Research ◽

10.1002/mnfr.202100342 ◽

2021 ◽

pp. 2100342

Author(s):

Luyang Hong ◽

Lan Zhang ◽

Qi Zhou ◽

Shujuan Li ◽

Junyan Han ◽

...

Keyword(s):

Pilot Study ◽

Human Milk ◽

Necrotizing Enterocolitis ◽

Premature Infants ◽

Gut Microbiome ◽

Stage I

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Feeding the feeble

10.1093/med/9780198854807.003.0038 ◽

2021 ◽

pp. 265-272

Author(s):

Michael Obladen

Keyword(s):

Human Milk ◽

Preterm Infants ◽

Necrotizing Enterocolitis ◽

Premature Infants ◽

Tube Feeding ◽

Theoretical Knowledge ◽

Air Inlet ◽

Nasogastric Tubes ◽

Nutritional Needs ◽

The 1960S

This chapter describes historic steps in feeding techniques and knowledge about the nutritional needs of premature infants. Devices to overcome weak sucking and swallowing were developed from 1851 to 1920: tube feeding by gavage, medicine droppers and pipettes, feeding bottles with air inlet, and beaked spoons for nasal feeding. Indwelling nasogastric tubes were in use from 1951. For alleged safety concerns, postnatal feeding was postponed until a week of starvation was reached in the 1950s and studies showed an association with neurological handicaps. The premature infant’s elevated need for energy, protein, and minerals has been known since 1919. However, nutritional practice lagged behind theoretical knowledge. Concentrated formula was developed in the 1940s, parenteral supplementation in the 1960s, and human milk fortifiers in the 1970s. In the 1990s, necrotizing enterocolitis was found to be more frequent in infants fed formula than in those fed human milk. Recently, probiotics were shown to reduce the risk of necrotizing enterocolitis. Compared to other aspects of neonatal medicine, there is little evidence on how to feed preterm infants.

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P1816KIDNEY DAMAGE IN NECROTIZING ENTEROCOLITIS OF PREMATURE BORN INFANTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1816 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Iuliia Kyslova ◽

Nataliia Chornopyshchuk ◽

Olga Yablon ◽

Anastasiia Konoplitska ◽

Roman Chornopyshchuk

Keyword(s):

Necrotizing Enterocolitis ◽

Premature Infants ◽

Statistical Processing ◽

Kidney Damage ◽

Stage Ii ◽

Free Oxygen Radicals ◽

Long Term Effects ◽

Term Infants ◽

Group A ◽

Group B

Abstract Background and Aims Neonatal kidney damage can be the result of hypoxic-ischemic events or nephrotoxic drugs. The long-term effects of hypoxia on the kidneys are still unclear. Unlike full-term infants, premature infants of less than 36 weeks of gestational age exhibit persistent nephrogenesis According to literature database, ischemia as well as reperfusion and infection (hypoxia, acidosis, hypotension, the action of free oxygen radicals) are also major risk factors for necrotizing enterocolitis (NEC). The aim is to establish the peculiarities of kidney damage in necrotizing enterocolitis of premature infants who died from it and infants with NEC surviving. Method The study involved 54 of premature infants: 21 infants with NEC stage II and III who died (group A), 43 infants who survived with similar stages of NEC (group B). Statistical processing of the data obtained was carried out on a personal computer using STATISTICA 6.1 and IBM SPSS. Results Infants in group A had significantly higher body weight - (1371.2±70.5) g than infants in group B - (1163.9±51.6) g (p<0.05). Gender peculiarities were established: boys (66.7%) were significantly more prevalent in group A, i.e. there were twice more boys among the dead (χ2 = 7.679; p = 0.006). In 85.7% children with NEC stage II and III who died was diagnosed perinatal hypoxia and 90.5% infants of this group have perinatal infections, p<0.01. The level of serum urea and creatinine in children with NEC who died was significantly higher (21.2±2.9 mmol/l and 175.8±23.7 μmol/l respectively) than in premature infants who survived with NEC (6.8±0.6 mmol/l and 76.0±6.9 μmol/l, respectively), (p<0.01). Odds ratio (OR) of lethal outcome in premature infants with NEC and elevated levels of urea (OR = 12.364; 95% CI: 3.415–44.768) and creatinine (OR = 8.267; 95 % CI: 2.447-27.589). In premature infants who died, one of the most frequent causes of death was acute kidney damage - in 8 (38.1%) infants, among other causes one of the most common causes was endogenous intoxication in 8 (38.1%) infants, rarely other causes. Conclusion Hypoxia and infections during pregnancy and during the birth of premature infants played a significant role in develop of kidney damage. Elevated levels of urea and creatinine in premature infants with NEC one of the factors that associated with mortality.

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