Abstract Although the pathogenesis of necrotizing enterocolitis (NEC) has yet to be delineated, there is ample evidence to support a role of intestinal bacteria in the genesis and complications of this disease in neonates. The importance of coliform bacilli has been demonstrated in experimental NEC in newborn rats, and sporadic outbreaks of NEC in neonatal intensive care units have frequently been associated with intestinal colonization or septicemia caused by various members of the Enterobacteriaceae family.1,2 Stanley and Null3 reported that temporal alterations in the intestinal microflora of infants were correlated with changes in the incidence of NEC and that neonates initially colonized with Klebsiella pneumoniae had an almost threefold greater likelihood of developing disease than those colonized with other enterobacterial species. Surveillance studies from one intensive care unit have shown that K pneumoniae and Escherichia coli strains are recovered significantly (P <.01) more often from rectal cultures of infants References 1. Barlow B, Santalli TV, Heird WG, et al: An experimental study of acute necrotizing enterocolitis . J Pediatr Surg 9:587-595, 1974.Crossref 2. Speer ME, Taker LH, Yow MD, et al: Fulminant neonatal sepsis and necrotizing enterocolitis associated with a "nonenteropathogenic" strain of Escherichia coli . J Pediatr 89:91-95, 1976.Crossref 3. Stanley MD, Null DM: Relationship between intestinal colonization with specific bacteria and the development of necrotizing enterocolitis . Pediatr Res 11:542, 1977. 4. Bell MJ, Feigin RD, Ternberg JL, et al: Evaluation of gastrointestinal microflora in necrotizing enterocolitis . J Pediatr 92:589-592, 1978.Crossref 5. Bell MJ, Kosloske AM, Benton C, et al: Neonatal necrotizing enterocolitis: Prevention of perforation . J Pediatr Surg 8:601-605, 1973.Crossref 6. Egan EA, Mantilla G, Nelson RM, et al: A prospective controlled trial of oral kanamycin in the prevention of neonatal necrotizing enterocolitis . J Pediatr 89:467-470, 1976.Crossref 7. Boyle R, Nelson JS, Ross B, et al: Alterations in stool flora resulting from oral kanamycin prophylaxis of necrotizing enterocolitis . J Pediatr , to be published. 8. Rowley MP, Dahlenburg GW: Gentamicin in prophylaxis of neonatal necrotising enterocolitis . Lancet 2:532, 1978.Crossref 9. Bell MJ, Ternberg JL, Feigin RD, et al: Neonatal necrotizing enterocolitis: Therapeutic decisions based upon clinical staging . Ann Surg 187:1-7, 1978.Crossref 10. Franco JA, Eitzman DV, Baer H: Antibiotic usage and microbial resistance in an intensive care nursery . Am J Dis Child 126:318-321, 1973. 11. Howard JB, McCracken GH: Reappraisal of kanamycin usage in neonates . J Pediatr 86:949-956, 1975.Crossref 12. Bartlett JG, Chang TW, Gurwith M, et al: Antibiotic-associated pseudomembranous colitis due to toxin-producing Clostridia . N Engl J Med 298:531-534, 1978.Crossref 13. Larson HE, Price AB, Honour P, et al: Clostridium difficile and the aetiology of pseudomembranous colitis . Lancet 1:1063-1066, 1978.Crossref 14. Pederson PV, Hansen FH, Halveg AB, et al: Necrotising enterocolitis of the newborn—is it gas-gangrene of the bowel? Lancet 2:715-716, 1976.Crossref 15. Howard FM, Flynn DM, Bradley JM, et al: Outbreak of necrotising enterocolitis caused by Clostridium butyricum . Lancet 2:1099-1102, 1977.Crossref 16. Weinstein L: Antibiotics , in Goodman LS, Gilman A (eds): The Pharmacological Basis of Therapeutics . London, Macmillan Co, 1970, pp 1269-1299.
American Journal of Diseases of Children – American Medical Association
Published: Dec 1, 1978