The intestinal microbiome is frequently implicated in necrotizing enterocolitis (NEC) pathogenesis. While no particular organism has been associated with NEC development, a general reduction in bacterial diversity and increase in pathobiont abundance has been noted preceding disease onset. However, nearly all evaluations of the preterm infant microbiome focus exclusively on the bacterial constituents, completely ignoring any fungi, protozoa, archaea, and viruses present. The abundance, diversity, and function of these nonbacterial microbes within the preterm intestinal ecosystem are largely unknown. Here, we review findings on the role of fungi and viruses, including bacteriophages, in preterm intestinal development and neonatal intestinal inflammation, with potential roles in NEC pathogenesis yet to be determined. In addition, we highlight the importance of host and environmental influences, interkingdom interactions, and the role of human milk in shaping fungal and viral abundance, diversity, and function within the preterm intestinal ecosystem.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10144239 | PMC |
http://dx.doi.org/10.3390/microorganisms11040909 | DOI Listing |
Pediatr Surg Int
January 2025
Department of General and Thoracic Surgery, The Hospital for Sick Children, University of Toronto, 1526-555 University Ave, Toronto, ON, M5G 1X8, Canada.
Purpose: Necrotizing enterocolitis (NEC) majorly affects premature infants, causing not only necrosis and inflammation but also feeding intolerance and gastrointestinal dysmotility, hinting at gut hormone secretion impairment. Particularly critical is the gestation period before 26 weeks where intestinal hormonal activity is partially developed, rendering preterm neonates highly susceptible to NEC. Emerging evidence suggests a role of gut hormones, especially glucagon-like peptides (GLP) in ileum development.
View Article and Find Full Text PDFIntestinal obstruction is a rare but life-threatening incidence in pregnancy. Diagnosis can be challenging for clinicians as the symptoms might be approached as other common obstetric complications. Performing radiological and abdominal surgery are also areas of great concern in this field; since radiologic studies inevitably expose the fetus to radiation and the treatment options mostly involve surgery that is worrisome during gestation.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore.
We report a case of small bowel perforation from ileo-ileal intussusception with necrotising enterocolitis (NEC) after indomethacin exposure mimicking spontaneous intestinal perforation in an extremely preterm neonate. Indomethacin exposure can cause mesenteric hypoperfusion, resulting in an ischaemic lead point for intussusception and NEC. We advocate that intussusception should be considered as one of the differentials for neonates with recurrent feeding intolerance postindomethacin exposure.
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