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The Role of Host Factors in an Outbreak of Necrotizing Enterocolitis FREE

Robert P. Gaynes, MD; Stephen Palmer, MB, BChir, MFCM; William J. Martone, MD; Cathy L. Holt, RN; Dona S. Buchter, MD; Loretta W. Frawley, RN, MS; Carl Perlino, MD; William P. Kanto, MD
[+] Author Affiliations

Reprint requests to Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, GA 30333 (Dr Gaynes).


Am J Dis Child. 1984;138(12):1118-1120. doi:10.1001/archpedi.1984.02140500024007.
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• During an outbreak investigation of necrotizing enterocolitis (NEC) in a neonatal intensive care unit, we identified nine definite and six suspected cases of NEC on the basis of histopathologic, clinical, and roentgenographic findings. Neonates of low birth weight (<1,250 g) had the highest incidence of NEC, supporting a role for prematurity in this disease. Patients with definite NEC and those with severe clinical features had significantly lower birth weights and postconception ages (gestational age at birth plus postnatal age at onset of NEC) than the patients with suspected NEC. In a case-control study using birth weight-matched control subjects, maternal toxemia was identified as a possible protective factor for NEC. To our knowledge, this is the first report of the relationship between NEC disease severity and postconception age. These findings also suggest that toxemia may be an important protective factor in NEC and should be examined in subsequent studies.

(AJDC 1984;138:1118-1120)

REFERENCES

Santulli TV, Schullinger JN, Heird WC, et al:  Acute necrotizing enterocolitis in infancy: A review of 64 cases . Pediatrics 1975;;55:376-380.
Stoll BJ, Kanto WP Jr, Glass RI, et al:  Epidemiology of necrotizing enterocolitis: A case control study . J Pediatr 1980;;90:447-450.
Wilson R, Kanto WP Jr, McCarthy BJ, et al:  Age at onset of necrotizing enterocolitis: Risk factors in small infants . AJDC 1982;;136:814-816.
Wilson R, Kanto WP Jr, McCarthy BJ, et al:  Age at onset of necrotizing enterocolitis: An epidemiologic analysis . Pediatr Res 1982;;16: 82-84.
Kanto WP, Breart R, Wilson R, et al:  Epidemiology of necrotizing enterocolitis (NEC): Implications for etiology , abstracted. Pediatr Res 1982;;17:178.
Gluck L, Kulovich MV:  Lecithin/sphingomyelin ratios in amniotic fluid in normal and abnormal pregnancy . Am J Obstet Gynecol 1973;;115:539-544.
Morrison JC, Whybrew WD, Bucovaz ET, et al:  The lecithin/sphingomyelin ratio in cases associated with fetomaternal disease . Am J Obstet Gynecol 1977;;127:363-367.
Ballows A, Hausler WJ (eds): Diagnostic Procedures for Bacterial, Mycotic, and Parasitic Infections . Washington, DC, American Public Health Association Inc, 1981;.
Lennette EH, Schmidt NJ (eds): Diagnostic Procedures for Viral, Rickettsial, and Chlamydial Infections . Washington, DC, American Public Health Association Inc, 1979;.
Lloyd JR:  The etiology of gastrointestinal perforation of the newborn . J Pediatr Surg 1969;;4:77-81.
Wilson R, del Portillo M, Schmidt E, et al:  Risk factors for necrotizing enterocolitis in infants weighing more than 2,000 grams at birth: A case-control study . Pediatrics 1983;;71:19-22.
Kliegman RM, Jones MHP, Fanaroff AA:  Epidemiologic study of necrotizing enterocolitis among low-birth-weight infants . J Pediatr 1982;;100:440-445.
Rotbart HA, Levin MJ:  How contagious is necrotizing enterocolitis? Pediatr Infect Dis 1983;;2:406-413.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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References

Santulli TV, Schullinger JN, Heird WC, et al:  Acute necrotizing enterocolitis in infancy: A review of 64 cases . Pediatrics 1975;;55:376-380.
Stoll BJ, Kanto WP Jr, Glass RI, et al:  Epidemiology of necrotizing enterocolitis: A case control study . J Pediatr 1980;;90:447-450.
Wilson R, Kanto WP Jr, McCarthy BJ, et al:  Age at onset of necrotizing enterocolitis: Risk factors in small infants . AJDC 1982;;136:814-816.
Wilson R, Kanto WP Jr, McCarthy BJ, et al:  Age at onset of necrotizing enterocolitis: An epidemiologic analysis . Pediatr Res 1982;;16: 82-84.
Kanto WP, Breart R, Wilson R, et al:  Epidemiology of necrotizing enterocolitis (NEC): Implications for etiology , abstracted. Pediatr Res 1982;;17:178.
Gluck L, Kulovich MV:  Lecithin/sphingomyelin ratios in amniotic fluid in normal and abnormal pregnancy . Am J Obstet Gynecol 1973;;115:539-544.
Morrison JC, Whybrew WD, Bucovaz ET, et al:  The lecithin/sphingomyelin ratio in cases associated with fetomaternal disease . Am J Obstet Gynecol 1977;;127:363-367.
Ballows A, Hausler WJ (eds): Diagnostic Procedures for Bacterial, Mycotic, and Parasitic Infections . Washington, DC, American Public Health Association Inc, 1981;.
Lennette EH, Schmidt NJ (eds): Diagnostic Procedures for Viral, Rickettsial, and Chlamydial Infections . Washington, DC, American Public Health Association Inc, 1979;.
Lloyd JR:  The etiology of gastrointestinal perforation of the newborn . J Pediatr Surg 1969;;4:77-81.
Wilson R, del Portillo M, Schmidt E, et al:  Risk factors for necrotizing enterocolitis in infants weighing more than 2,000 grams at birth: A case-control study . Pediatrics 1983;;71:19-22.
Kliegman RM, Jones MHP, Fanaroff AA:  Epidemiologic study of necrotizing enterocolitis among low-birth-weight infants . J Pediatr 1982;;100:440-445.
Rotbart HA, Levin MJ:  How contagious is necrotizing enterocolitis? Pediatr Infect Dis 1983;;2:406-413.

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