AUTHOR=Du Ting-Ting , Liu Xiao-Chen , He Yu , Gao Xiong , Liu Zhen-Zhen , Wang Zheng-Li , Li Lu-Quan 

TITLE=Changes of gut microbiota and tricarboxylic acid metabolites may be helpful in early diagnosis of necrotizing enterocolitis: A pilot study

JOURNAL=Frontiers in Microbiology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2023.1119981

DOI=10.3389/fmicb.2023.1119981

ISSN=1664-302X

ABSTRACT=<sec><title>Purpose</title><p>We aimed to explore the value of gut microbiota and tricarboxylic acid (TCA) metabolites in early diagnosis of necrotizing enterocolitis (NEC) among infants with abdominal manifestations.</p></sec><sec><title>Methods</title><p>Thirty-two preterm infants with abdominal manifestations at gestational age ≤ 34 weeks were included in the study and were divided into non-NEC (<italic>n</italic> = 16) and NEC (<italic>n</italic> = 16) groups. Faecal samples were collected when the infants were enrolled. The gut microbiota was analysed with high-throughput sequencing, and TCA metabolites were measured with multiple reaction monitoring (MRM) targeted metabolomics. Receiver operating characteristic (ROC) curves were generated to explore the predictive value of the obtained data.</p></sec><sec><title>Results</title><p>There was no significant difference in alpha diversity or beta diversity between the two groups (<italic>p</italic> &gt; 0.05). At the phylum level, <italic>Proteobacteria</italic> increased, and <italic>Actinomycetota</italic> decreased in the NEC group (<italic>p</italic> &lt; 0.05). At the genus level, <italic>Bifidobacterium</italic> and <italic>Lactobacillaceae</italic> decreased significantly, and at the species level, <italic>unclassified Staphylococcus</italic>, <italic>Lactobacillaceae</italic> and <italic>Bifidobacterium animalis subsp. lactis</italic> decreased in the NEC group (<italic>p</italic> &lt; 0.05). Further Linear discriminant analysis effect sizes (<italic>LEfSe</italic>) analysis showed that the change in <italic>Proteobacteria</italic> at the phylum level and <italic>Lactobacillaceae</italic> and <italic>Bifidobacterium</italic> at the genus level scored higher than 4. The concentrations of succinate, L-malic acid and oxaloacetate in the NEC group significantly increased (<italic>p</italic> &lt; 0.05), and the areas under the ROC curve for these metabolites were 0.6641, 0.7617, and 0.7344, respectively.</p></sec><sec><title>Conclusion</title><p>Decreased <italic>unclassified Staphylococcus</italic>, <italic>Lactobacillaceae</italic> and <italic>Bifidobacterium animalis subsp. lactis</italic> at the species level as well as the increase in the contents of some TCA metabolites, including succinate, L-malic acid and oxaloacetate, have potential value for the early diagnosis of NEC.</p></sec>