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1、SeminarsinPediatricSurgery22(2013)69–75ContentslistsavailableatSciVerseScienceDirectSeminarsinPediatricSurgeryjournalhomepage:www.elsevier.com/locate/sempedsurgRegulararticleTheroleoftheintestinalmicrobiotainthepathogenesisofnecrotizingenterocolitisnAnatolyGrishin,PhD,StephaniePapillon,MD,Brando

2、nBell,BS,JinWang,MS,HenriR.Ford,MD,MHADepartmentofSurgery,UniversityofSouthernCalifornia,andDivisionofPediatricSurgery,ChildrensHospitalLosAngeles,4650SunsetBlvd,Mailstop72,LosAngeles,California90027articleinfoabstractDevelopmentofnecrotizingenterocolitis(NEC)requiresasusceptiblehost,typicallyap

3、rematureinfantKeywords:oraninfantwithcongenitalheartdisease,enteralfeedingsandbacterialcolonization.AlthoughthereisNecrotizingenterocolitislittledoubtthatmicrobesarecriticallyinvolvedinthepathogenesisofNEC,theidentityofspeci?cNeonatalgutmicrobiotacausativepathogensremainselusive.Unlikeestablishe

4、dnormaladultgutmicrobiota,whichisquitePrematureinfantcomplex,uniform,andstable,earlypostnatalbacterialpopulationsaresimple,diverse,and?uid.TheseOpportunisticpathogenspropertiescomplicatestudiesaimedatelucidatingcharacteristicsofthegutmicrobiomethatmayplayaroleinthepathogenesisofNEC.Abroadvariety

5、ofbacterial,viral,andfungalspecieshavebeenimplicatedinbothclinicalandexperimentalNEC.Frequently,however,thesamespecieshavealsobeenfoundinphysiologicallymatchedhealthyindividuals.ClusteredoutbreaksofNEC,inwhichthesamestrainofasuspectedpathogenisdetectedinseveralpatientssuggest,butdonotprove,acaus

6、ativerelationshipbetweenthespeci?cpathogenandthedisease.StudiesinCronobactersakazakii,thebestcharacterizedNECpathogen,havedemonstratedthatvirulenceisnotapropertyofabacterialspeciesasawhole,butratheracharacteristicofcertainstrains,whichmayexplainwhythesamespeciescanbepathogenicornon-pathogenic.Th

7、efactthatagivenmicrobemaybeinnocuousinafull-term,yetpathogenicinapre-terminfanthasledtotheideaofopportunisticpathogensinNEC.ProgressinunderstandingtheinfectiousnatureofNECmayrequireidentifyingspeci?cpathogenicstrainsandunamb