Abstract
During a 4 day period, 3 premature infants developed NEC. All had abdominal distention, guaiac + stools, intolerance of feedings, apnea and pneumatosis intestinalis. One developed a perforation of the small bowel. A pure culture of E. coli resistant to all common antibiotics except chloramphenicol and gentamicin was obtained from the peritoneal cavity of that infant. Using media containing 20 μg/ml of kanamycin, stools of all infants in the nursery were screened for this organism. Seven infants, including the 3 with NEC were found to have a kanamycin resistant E. coli and 14 did not. All 7 of the E. coli strains isolated were slow lactose fermenters, had similar antibiograms and were serotype 085. Of the 7 colonized infants, 3 had NEC as described above. Three others had guaiac + stools, intolerance of feedings and abdominal distention without pneumatosis intestinalis. Of the 14 infants who were not colonized with the implicated strain, none developed enterocolitis during a 4 week followup. All infants had received ampicllin and kanamycin prior to screening. A strain of E. coli, an organism often considered normal flora, may have contributed to a cluster of cases of NEC. Virulence factors, yet to be identified, may account for this association. If such associations between NEC and certain strains of Enterobacteraceae can be proven, secondary cases may be avoided by preventing colonization with such strains.
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Yeager, A., Mcnabb, M., Sullivan, D. et al. CLUSTER OF CASES OF NECROTIZING ENTEROCOLITIS (NEC) ASSOCIATED WITH E. COLI 085. Pediatr Res 11, 545 (1977). https://doi.org/10.1203/00006450-197704000-01052
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DOI: https://doi.org/10.1203/00006450-197704000-01052