Evolution of Gut Microbiome and Metabolome during Stage 1 Necrotizing Enterocolitis: a Case-Control Study

Abstract Background : Necrotizing enterocolitis (NEC) is a devastating condition of the preterm new-born due to multiple factors, including gut microbiota dysbiosis. Since NEC development is poorly understood due to main focus on late stages 2 and 3, we studied the gut microbiota and metabolome evolution of NEC at a very early onset. Results NEC-1 gut microbiota had a higher abundance of Streptococcus (second decade of life) and Staphylococcus (third decade of life) species. NEC-1 children showed a microbiome evolution in the third decade of life being the most divergent and associated to a different metabolomic signature than in healthy children. NEC-1 microbiome had increased glycosaminoglycan degradation and lysosome activity by the first decade of life and was more sensitive to factors such as childbirth, low birth weight and gestational age, than healthy microbiome. NEC-1 fecal metabolome was more divergent by the second month of life. Conclusions: The modifications of gut microbiota and microbiome during NEC-1 development appear more distinguishable by the third decade of life, when compared to healthy children. These data identify a precise window of time (i.e. third decade of life) and provide microbial targets to fight/blunt the progression of NEC by stage 1.