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Microbiological study correlated with

pathological aspects of newborn enterocolitisCamelia Budisan (1), Rodica Ilie (2), *Constantin Ilie (1), Enatescu Ileana (1),

Mirabela Dima (1), Ioana Bortea (1), Cristina Moldovan (1)

Results

An important incidence of the enterocolitis among the total newborns with letal evolution in the studied

period (7,33%).

A great prevalence of the disease to the premature newborn 33,33%(9/27) - (Chart 1) and the age to the

death(Table 2);

In abnormal pregnancy and birth : maternal infections 11,74%; premature rupture membrane 18,61%;

coloured amniotic liquid 26,56% ; APGAR less than 551,96% ; intensive therapy needed to birth

20,16%.

The microbiological study revealed : Enterobacter 11,11%; Pyocianic 7,4%; Escherichia coli 3,7%;

Staphilococus aureus 22,22%; Candida albicans 7,4%; Klebsiella 11,11% - (Chart 3);

Pathological forms of the enterocolitis were : pyo-haemorrhagical 77,77%; haemorrhagical 22,22% -

(Fig. 1, 2);

Pathological complications discovered were : peritonitis 29,62%; bowel perforation 14,81% - (Fig. 3, 4).

Fig. 2 Haemorrhagical necrotizing

enterocolitis, with thrombosis of some loops

ConclusionsWe consider that in the Bell III necrotizing enterocolitis, the risk factors as:maternalinfectionsduringthepregnancy,

prematurity, intensive therapy needs at birth, infectious factors, lead to hypoxia with bacterial migration from the

intestinal lumen, inhibition of suppresor pathways, massive cytokines release with systemic sepsis and multiple organfailure.

Necrotizing enterocolitis remains one of the most common emergencies for the newborn because of the usual

complications : peritonitis and bowel perforation, leading to death.

References1. Hsueh W, Caplan MS, Qu XW, Tan XD, De Plaen IG, Gonzalez-Crussi F. Neonatal necrotizing enterocolitis: clinical considerations and pathogenetic concepts. Pediatr Dev

Pathol 2003;6(1):6-23;

2. Henry MC, Lawrence Moss R. Surgical therapy for necrotizing enterocolitis: bringing evidence to the bedside. Semin Pediatr Surg 2005;14(3):181-90;

3. Lin PW, Stoll BJ. Necrotising enterocolitis. Lancet 2006;368(9543):1271-83.

(1) University of Medicine and Pharmacy, Neonatology, Timisoara, Romania;

(2) Emergency Children Hospital, Pathology, Timisoara, Romania

Fig.1 Classic findings of diffuse pyo-

haemorrhagical necrotizing enterocolitisFig. 3 H.E., x10. Destruction of villi, dilated

capillary and inflammatory cells

Fig. 4 H.E., x20. Necrotizing peritonitis, with

thrombosis and some areas of pneumatosis

STU

DY

YEA

RS

AGE OF THE NEWBORNS

TO THE DEATH (DAYS)

1-7 8-14 15-21 22-302004 3 2 1 12005 4 2 1 22006 2 1 - 22007 1 1 - -2008 - - - 22009 - - - 2

TOTAL 10 6 2 9Table 2 Age of the newbornChart 1 Prematurity Chart 2 Microbiological study

Background

We intended to determine the prevalence of the microbiological pathogens in necrotizing enterocolitis,

correlated with the pathological aspects and abnormal pregnancy and birth signs, as an important neonatal

death cause.

Microbiological study

3,70%

22,22%

11,11%

11,11%

37,06% 7,40%

7,40%

Enterobacter

Pyocianic

Escherichia coliStaphilococus aureus

Candida albicans

Klebsiella

Unknown

Incidence of prematurity

33.33 %66.66 %

Premature

newborns