Toggle Main Menu Toggle Search

Open Access padlockePrints

Temporal bacterial and metabolic development of the preterm gut reveals specific signatures in health and disease

Lookup NU author(s): Dr Christopher StewartORCiD, Professor Nicholas EmbletonORCiD, Dr Thomas Skeath, Dr John Perry, Dr Janet Berrington



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Background: The preterm microbiome is crucial to gut health and may contribute to necrotising enterocolitis (NEC), which represents the most significant pathology affecting preterm infants. From a cohort of 318 infants, <32 weeks gestation, we selected 7 infants who developed NEC (defined rigorously) and 28 matched controls. We performed detailed temporal bacterial (n = 641) and metabolomic (n = 75) profiling of the gut microbiome throughout the disease.Results: A core community of Klebsiella, Escherichia, Staphyloccocus, and Enterococcus was present in all samples. Gut microbiota profiles grouped into six distinct clusters, termed preterm gut community types (PGCTs). Each PGCT reflected dominance by the core operational taxonomic units (OTUs), except of PGCT 6, which had high diversity and was dominant in bifidobacteria. While PGCTs 1-5 were present in infants prior to NEC diagnosis, PGCT 6 was comprised exclusively of healthy samples. NEC infants had significantly more PGCT transitions prior to diagnosis. Metabolomic profiling identified significant pathways associated with NEC onset, with metabolites involved in linoleate metabolism significantly associated with NEC diagnosis. Notably, metabolites associated with NEC were the lowest in PGCT 6.Conclusions: This is the first study to integrate sequence and metabolomic stool analysis in preterm neonates, demonstrating that NEC does not have a uniform microbial signature. However, a diverse gut microbiome with a high abundance of bifidobacteria may protect preterm infants from disease. These results may inform biomarker development and improve understanding of gut-mediated mechanisms of NEC.

Publication metadata

Author(s): Stewart CJ, Embleton ND, Marrs ECL, Smith DP, Nelson A, Abdulkadir B, Skeath T, Petrosino JF, Perry JD, Berrington JE, Cummings SP

Publication type: Article

Publication status: Published

Journal: Microbiome

Year: 2016

Volume: 4

Online publication date: 29/12/2016

Acceptance date: 01/12/2016

Date deposited: 01/03/2017

ISSN (electronic): 2049-2618

Publisher: BioMed Central Ltd.


DOI: 10.1186/s40168-016-0216-8


Altmetrics provided by Altmetric