Intestinal microbiome changes in an infant with right atrial isomerism and recurrent necrotizing enterocolitis: A case report and review of literature

Table 6 Results of 16S rRNA gene-based fecal microbiota profiling in serial fecal samples of the neonate

POD (DOL)	Class level	Family level	Genus level
Before surgical treatment of CHD (DOL 7) – feeding with fortified BM with preterm formula added (because of low BM supply)
- (7)	Negativicutes 44.9%	Veillonellaceae 44.9%	Veillonella 44.9%
	Gammaproteobacteria 41.1%	Enterobacteriaceae 38.8% Pasteurellaceae 2.3%	Escherichia/Shigella 38.8%
	Bacilli 12.3%	Streptococcaceae 8.0% Enterococcaceae 4.3%	Streptococcus 8.0% Enterococcus 4.3%
Before surgical treatment of CHD (DOL 14) – before the first episode of NEC stage IIA on POD 1 (DOL 15) Feeding with fortified BM with preterm formula added (because of low BM supply)
- (14)	Clostridia 57.8%	Clostridiaceae 57.8%	Clostridium sensu stricto I 57.8% 1Clostridium paraputrificum 56.1%
	Gammaproteobacteria 29.6%	Enterobacteriaceae 24.8% Pasteurellaceae 4.8%	Escherichia/Shigella 24.8% Actinobacillus 4.8%
	Bacilli 5.7%	Streptococcaceae 5.7%	Streptococcus 5.7%
	Actinobacteria 3.8%	Bifidobacteriaceae 3.8%	Bifidobacterium 3.8%
	Negativicutes 3.1%	Veillonellaceae 3.1%	Veillonella 3.1%
POD 8 (DOL 22) – after ampicillin/sulbactam therapy (POD 1-7) and metronidazole therapy (POD 2-6) had been completed and piperacillin/tazobactam therapy was started (POD 7-14) (nil per os)
8 (22)	Gammaproteobacteria 99.8%	Enterobacteriaceae 99.8%	Escherichia/Shigella 99.8%
	Clostridia 0.2%	Ruminococcaceae 0.2%	1Ruminococcus bucirculans 0.2%
POD 21 (DOL 35) – 7 d after the antibacterial therapy was completed on POD 14 Feeding with hydrolyzed formula
21 (35)	Clostridia 58.0%	Clostridiaceae 56.9% Lachnospiraceae 1.1%	Clostridium sensu stricto I 56.9% Anaerostripes 1.1%
	Gammaproteobacteria 38.7%	Enterobacteriaceae 38.7%	Escherichia/Shigella 38.7%
	Bacilli 3.2%	Enterococcaceae 3.2%	Enterococcus 3.2%
POD 29 (DOL 43) – on the day after onset of the second episode of NEC IIA Feeding before NEC IIA onset: Expressed BM (from DOL 37) with hydrolyzed formula dotation
29 (43)	Clostridia 72.0%	Clostridiaceae 72.0%	Clostridium sensu stricto I 72.0%
	Gammaproteobacteria 22.7%	Enterobacteriaceae 19.8% Pasteurellaceae 2.9%	Escherichia/Shigella 18.1%
	Negativicutes 5.3%	Veillonellaceae 5.3%	Veillonella 5.3%

¹Species level.

POD: Postoperative day; DOL: Day of life; CHD: Congenital heart disease; BM: Breast milk; NEC: Necrotizing enterocolitis.