Fecal microbiota transplantation decreases necrotizing enterocolitis but is associated with increased neonatal mortality in preterm pigs

Introduction: Necrotizing enterocolitis (NEC) remains a common gastrointestinal disease in preterm infants. Inappropriate bacterial colonization of the gut, together with enteral formula feeding, predispose to NEC in both preterm infants and preterm pigs. Regardless, it remains unclear how and when to manipulate the gut microbiota (e.g. by use of pre-, proor antibiotics) to improve mucosal immunity and NEC resistance. We hypothesized that fecal microbiota transplantation (FMT) to neonatal preterm pigs would support their initial gut colonization and thereby reduce formula-induced NEC development.