Sepsis is a clinical term for a systemic bacterial infection which can damage the vital organs and be fatal. It is actually more common than a heart attack and causes more deaths globally than cancer, yet many of us haven’t heard of it. Sepsis tends to affect those at the most vulnerable ends of the age spectrum – the elderly and newborns. In infants, this disease results in an estimated 1 million annual deaths worldwide, with most of these being in developing countries.

Bearing these shocking statistics in mind, a new, large clinical study showing that probiotic intervention could dramatically reduce the chances of a newborn developing sepsis, is good news indeed.


Sepsis is more common than we realise among newborns, especially in developing countries
Sepsis is more common than we realise among newborns, especially in developing countries

The study

The study just published in Nature, led by Pinaki Panigrahi, a professor at the University of Nebraska, studied 4,556 full term newborns from the rural area Odisha state in India where the rates of infant death are particularly high.

This was a randomised, double-blind, placebo-controlled trial using an oral preparation of a probiotic bacteria Lactobacillus plantarum ATCC-202195 mixed with a prebiotic, Fructooligosaccharides (FOS), that is thought to feed our beneficial gut bacteria. A total of 4,556 full term infants showing no sign of sepsis or other illness, were given either a placebo preparation or the probiotic preparation at between 2-4 days after birth, for up to a week and then monitored for 60 days. The result was a significant 40% reduction in the probiotic group of fatality due to sepsis. Interestingly also, among those infants who were hospitalized with a microbial infection, 27 were in the placebo group and 6 in the treatment group. The results also showed that the probiotic combination reduced the occurrence of other types of infection as well, with the probiotic group seeing a 30% reduction in respiratory infections.

These findings suggest that neonatal sepsis in developing countries could potentially be effectively reduced using a probiotic bacteria such as L. plantarum ATCC-202195.
“This is an amazing study because it used a large sample of mostly full-term infants to rigorously assess whether a particular probiotic/prebiotic combination could reduce the incidence of late-onset clinical sepsis in a part of the world where there is a very high disease burden from such infections,” - Daniel Tancredi, a statistician in the department of pediatrics at the University of California.
The clinical study was run in the full-term newborns in the Odisha state in India where infant mortality is high
The clinical study was run in the full-term newborns in the Odisha state in India where infant mortality is high

Discussion

It may seem a little strange to fight what is essentially a bacterial infection with more bacteria. However, as we are finding out, gut bacteria have a myriad of functions which benefit our health, both in the gut but also for the rest of the body.

We know that healthy bacteria may help to combat and push out harmful bacteria residing in the gut – either by simply overwhelming the harmful bacteria in numbers, or by using up available resources. As we also know, the healthy bacteria produce compounds that strengthen and protect the intestine wall and therefore the integrity and control of what is passed between the intestine and the blood. Finally, gut bacteria are a vital part of a stable and healthy immune system. All of these qualities of healthy gut bacteria could contribute to maintaining a healthy balance of bacteria in the body, preventing harmful bacteria from taking over and causing illness.
Dr Pascal Lavoie, a neonatologist at the BC Children’s Hospital in Vancouver says "It (beneficial bacteria) acts as a barrier to prevent the bad bacteria from going through the wall into the blood…They can (also) promote maturation of the immune system in a healthier way…..Probiotics can be much more powerful than drugs. Sepsis is such an important problem around the world," Lavoie says. "This study has huge potential."
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Reference: P. Panigrahi et al., “A randomized synbiotic trial to prevent sepsis among infants in rural India,” Nature, doi:10.1038/nature23480, 2017.

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