Hassan EH, Zaghloul W, Ahmed SM, Ghozi AM, Abdelwahab IA. Study of the gut microbiome profile in full-term infants with necrotizing enterocolits. World J Clin Pediatr 2026; 15(2): 112551 [DOI: 10.5409/wjcp.v15.i2.112551]
Corresponding Author of This Article
Wessam Zaghloul, MD, PhD, Department of Pediatrics, Faculty of Medicine Alexandria University, 22 El-Guish Road, El-Shatby, Alexandria 21526, Egypt. wessam.ahmed@alexmed.edu.eg
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Pediatrics
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Case Control Study
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Jun 9, 2026 (publication date) through May 16, 2026
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Publication Name
World Journal of Clinical Pediatrics
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2219-2808
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Hassan EH, Zaghloul W, Ahmed SM, Ghozi AM, Abdelwahab IA. Study of the gut microbiome profile in full-term infants with necrotizing enterocolits. World J Clin Pediatr 2026; 15(2): 112551 [DOI: 10.5409/wjcp.v15.i2.112551]
World J Clin Pediatr. Jun 9, 2026; 15(2): 112551 Published online Jun 9, 2026. doi: 10.5409/wjcp.v15.i2.112551
Study of the gut microbiome profile in full-term infants with necrotizing enterocolits
Eman Hamza Hassan, Wessam Zaghloul, Shwikar Mahmoud Ahmed, Ahmed M Ghozi, Ibrahim A Abdelwahab
Eman Hamza Hassan, Wessam Zaghloul, Department of Pediatrics, Faculty of Medicine Alexandria University, Alexandria 21526, Egypt
Shwikar Mahmoud Ahmed, Department of Medical Microbiology and Immunology, Faculty of Medicine Alexandria University, Alexandria 21526, Egypt
Ahmed M Ghozi, Department of Clinical Pharmacy, Pediatric Surgery and Internal Medicine Units, Alexandria 21526, Egypt
Ibrahim A Abdelwahab, Department of Microbiology and Immunology, Faculty of Pharmacy, Pharos University in Alexandria, Alexandria 21648, Egypt
Author contributions: Hassan EH obtained ethical approval, and was major contributor to the writing of the manuscript; Zaghloul W analyzed and interpreted the data from cases and controls regarding necrotizing enterocolitis disease; Ahmed SM performed the laboratory examination of stool samples via real-time polymerase chain reaction and reported the individual case results; Ghozi AM was responsible data collection, as well as for collecting and transporting stool samples; Abdelwahab IA conceptualized and designed the study, supervised the research process, and critically reviewed and revised the manuscript for important intellectual content. All authors have read and approved the final manuscript.
Institutional review board statement: Ethical approval was obtained from the Local Ethical Committee, Faculty of Medicine, Alexandria University (IRB No. 00012098).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: All the data generated or analyzed during this study are included in this published article. The underlying datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
Corresponding author: Wessam Zaghloul, MD, PhD, Department of Pediatrics, Faculty of Medicine Alexandria University, 22 El-Guish Road, El-Shatby, Alexandria 21526, Egypt. wessam.ahmed@alexmed.edu.eg
Received: July 31, 2025 Revised: September 10, 2025 Accepted: December 23, 2025 Published online: June 9, 2026 Processing time: 287 Days and 4.9 Hours
Abstract
BACKGROUND
Necrotizing enterocolitis (NEC) is a severe gastrointestinal disease that primarily affects preterm. Recently, cases with similar clinical manifestations have been observed in full-term infants without Hirschsprung’s disease. Dysbiosis suggested to have role in development of NEC.
AIM
To compare the gut microbiome composition between full term infants with NEC and healthy controls and to evaluate the impact of feeding sources on microbial diversity.
METHODS
Ten full term infants with NEC and six matched healthy breastfed control infants were enrolled in the study. Triplicate stool samples were collected from the enrolled infants. Genomic DNA was isolated and subjected to polymerase chain reaction analysis.
RESULTS
Bacteroidetes and Bacteroides were more abundant in control infants than in NEC cases, although the differences were statistically insignificant (P = 0.118 and P = 0.147, respectively), with large and moderate effect sizes. Bifidobacteria levels were significantly greater when a relaxed threshold (P ≤ 0.1) was used in both the control and NEC breastfed groups than in the NEC formula-fed group (P = 0.098). Additionally, alpha diversity was significantly reduced at the 0.1 level in NEC patients, especially among formula-fed infants (P = 0.094).
CONCLUSION
Full-term Egyptian infants with NEC exhibit reduced microbial diversity and alterations in bacterial abundance, supporting a potential link between dysbiosis and NEC. Feeding practices, particularly breastfeeding, appear to influence the gut microbiome profile regardless of NEC status. Although Bacteroidetes and Bacteroides did not reach statistical significance, their effect sizes suggest a need for further investigation into their roles in NEC pathogenesis in full-term infants.
Core Tip: The study aims to map the gut microbiome profile of full-term infants with non-Hirschsprung’s [necrotizing enterocolitis (NEC)] in Egypt and to relate the gut microbiome profile of non-Hirschsprung’s NEC in full-term infants to the source of the feeding factor. The study aims to compare the gut microbiome profile between NEC infants and healthy controls. The study was conducted in the Department of Pediatrics, Alexandria University.
