11. Necrotizing Enterocolitis and Gastrointestinal Infections

  1. David Isaacs

Published Online: 22 NOV 2013

DOI: 10.1002/9781118636657.ch11

Evidence-Based Neonatal Infections

Evidence-Based Neonatal Infections

How to Cite

Isaacs, D. (2013) Necrotizing Enterocolitis and Gastrointestinal Infections, in Evidence-Based Neonatal Infections, John Wiley & Sons Ltd, Chichester, UK. doi: 10.1002/9781118636657.ch11

Publication History

  1. Published Online: 22 NOV 2013
  2. Published Print: 18 DEC 2013

ISBN Information

Print ISBN: 9780470654606

Online ISBN: 9781118636657



  • gastrointestinal infections;
  • gut ischaemia;
  • infection control;
  • necrotizing enterocolitis (NEC);
  • neonatal diarrhoea


Necrotizing enterocolitis (NEC) is primarily a disease of prematurity and only 5-10% of cases occur in full-term infants. The incidence of NEC varies between different neonatal units and often varies within the same neonatal unit over time. NEC is characterized histopathologically by extensive inflammation of the gut with ischaemia and necrosis of the intestinal epithelium. The early radiographic signs of NEC are non-specific, showing abdominal distension and generalized bowel dilatation, suggestive but not diagnostic of ileus. The empiric antibiotic regimen for NEC is generally recommended to include anti-staphylococcal cover (vancomycin if MRSA is prevalent or the infant is colonized) and appropriate Gram-negative cover. The incidence of neonatal diarrhoea is rarely reported separately from the incidence of diarrhoea in older infants. Much neonatal diarrhoea occurs in the home, making incidence data more difficult to collect. Good infection control is the primary method of preventing neonatal diarrhoeal disease.