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Intestinal microbiome changes in an infant with right atrial isomerism and recurrent necrotizing enterocolitis:A case report and review of literature

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World Journal of Clinical Cases 2022年第29期10卷 10583-10599页

作者： Aleksandra Kaplina Ekaterina Zaikova Artem Ivanov Yulia Volkova Tatiana Alkhova Vladimir Nikiforov Alexander Latypov marina khavkina Tatiana Fedoseeva Tatiana Pervunina Yulia Skorobogatova Svetlana Volkova Vladimir Ulyantsev Olga Kalinina Stanislav Sitkin Natalia Petrova Research Laboratory of Physiology and Diseases of Newborns Almazov National Medical Research CentreSt.Petersburg 197341Russia Research Laboratory of Autoimmune and Autoinflammatory Diseases Almazov National Medical Research CentreSt.Petersburg 197341Russia Vladimir Ulyantsev International Laboratory of Computer TechnologiesITMO UniversitySt.Petersburg 197101Russia Department of Cardiovascular Surgery for Children Almazov National Medical Research CentreSt.Petersburg 197341Russia Department of Neonatal Physiology with an ICU Ward Almazov National Medical Research CentreSt.Petersburg 197341Russia Pediatric Cardiac Intensive Care Unit Almazov National Medical Research CentreSt.Petersburg 197341Russia Neonatal and Preterm Special Care Unit(2nd Stage Care) Almazov National Medical Research CentreSt.Petersburg 197341Russia Institute of Perinatology and Pediatrics Almazov National Medical Research CentreSt.Petersburg 197341Russia Express Laboratory of Perinatal Centre Almazov National Medical Research CentreSt.Petersburg 197341Russia Clinical Diagnostic Laboratory Almazov National Medical Research CentreSt.Petersburg 197341Russia Epigenetics and Metagenomics Group Institute of Perinatology and PediatricsAlmazov National Medical Research CentreSt.Petersburg 197341Russia Department of Internal Diseases Gastroenterology and DieteticsNorth-Western State Medical University named after I.I.MechnikovSt.Petersburg 191015Russia

BACKGROUND Necrotizing enterocolitis(NEC)is a multifactorial disease that predominantly affects premature *** dysbiosis plays a critical role in NEC pathogenesis in premature *** main risk factor for NEC in term infants is mesenteric hypoperfusion associated with ductaldependent congenital heart disease(CHD)that eventually leads to intestinal *** incidence of NEC in neonates with critical CHD is 6.8%-13%.However,the role of the intestinal microbiome in NEC pathogenesis in infants with ductal-dependent CHD remains *** SUMMARY A male term neonate with right atrial isomerism underwent modified Blalock-Taussig shunt placement on the 14^(th)day of life and had persistent mesenteric hypoperfusion after *** patient had episodes of NEC stageⅡA on the 1^(st)and 28^(th)days after cardiac *** microbial composition was analyzed before and after cardiac surgery by sequencing region V4 of the 16S rRNA *** surgery,species belonging to genera Veillonella and Clostridia and class Gammaproteobacteria were detected,Bifidobacteriaceae showed a low *** first NEC episode was associated with postoperative hemodynamic instability,intestinal ischemiareperfusion injury during cardiopulmonary bypass,and a high abundance of Clostridium paraputrificum(Clostridium sensu stricto I)(56.1%).Antibacterial therapy after the first NEC episode resulted in increased abundance of Gammaproteobacteria,decreased abundance of Firmicutes,and low alpha *** changes in the microbial composition promoted the growth of Clostridium sensu strictoⅠ(72.0%)before the second NEC *** A high abundance of Clostridium sensu strictoⅠand mesenteric hypoperfusion may have contributed to NEC in the present case.

关键词： Necrotizing enterocolitis Congenital heart disease Ivemark syndrome Heterotaxy Right atrial isomerism Intestinal microbiome Case report

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