A preterm neonate born at 28 weeks develops abdominal distension and bilious vomiting on day 12. Abdominal X-ray shows pneumatosis intestinalis. Which organism is most commonly implicated as the infectious trigger of this condition?

• A Clostridioides difficile
• B Staphylococcus epidermidis
• C Clostridium butyricum
• D Klebsiella pneumoniae ✓

Explanation

Necrotizing enterocolitis is a multifocal disease of prematurity driven by immature gut barrier, formula feeding, dysbiosis and inflammation. Klebsiella pneumoniae is among the most frequently isolated organisms from blood and stool in confirmed cases. Clostridial species including C. butyricum have been reported in outbreaks but are not the commonest isolate in standard texts.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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