The role of the preterm intestinal microbiome in sepsis and necrotising enterocolitis

Early Hum Dev. 2019 Nov;138:104854. doi: 10.1016/j.earlhumdev.2019.104854. Epub 2019 Aug 31.


Late-onset sepsis (LOS) and necrotising enterocolitis (NEC) account for the highest number of deaths in premature infants and often cause severe morbidity in survivors. NEC is an inflammatory mediated condition, but its pathophysiology remains poorly understood. There is increasing evidence that in LOS the causative organism most often translocates from the gut. No causative microorganism has been consistently associated with either LOS or NEC, but an aberrant gut microbiome development could play a pivotal role. A low bacterial diversity and a delay in anaerobic bacteria colonization may predispose preterm infants to disease development. Conversely, a predominance of Bifidobacterium species and breast milk feeding might help to prevent disease onset. With numerous studies reporting conflicting results, further research is needed to better understand the role of microorganisms and type of feeding in the health status of preterm infants.

Keywords: Gut; Microbiome; Necrotising enterocolitis; Preterm infant; Sepsis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Enterocolitis, Necrotizing / microbiology*
  • Enterocolitis, Necrotizing / pathology
  • Gastrointestinal Microbiome*
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Neonatal Sepsis / microbiology*
  • Neonatal Sepsis / pathology