Abstract
Clostridial infections have been associated with neonatal NEC. Neuraminidase, produced by Cl. perfringens and other clostridial species, cleaves neuraminic acid from the red blood cell glycoprotein and thus exposes a hidden receptor, the so-called Thomsen cryptantigen (T-Ag). Clostridial infection in NEC can thus be recognised by demonstration of the T-Ag on the patient's red blood cells. Among 22 cases with clinical signs of NEC 7 revealed T-antigen-positive erythrocytes. In one of those circulating neuraminidase was detectable for a short period. In 2 cases clostridial species were isolated from blood or peritoneal fluid cultures. The filtrates of these cultures were able to expose the T-Ag on normal red blood cells. Commercially available purified neuraminidase from Cl. perfringens unmasked the T-Ag on normal neutrophils and impaired function as measured by their killing of staphylococcus aureus. Our data indicate that screening of patients with NEC for the presence of T-Ag allows to delineate a subgroup of patients infected with neuraminidase-producing microorganisms. They also suggest that in this subgroups non-specific defense may be impaired.
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