Study shows probiotics can prevent sepsis in infants

August 17, 2017, University of Nebraska-Lincoln
Dr. Pinaki Panigrahi monitors a baby’s progress in a clinical trial in India. Credit: University of Nebraska Medical Center (UNMC)

A research team at the University of Nebraska Medical Center College of Public Health has determined that a special mixture of good bacteria in the body reduced the incidence of sepsis in infants in India by 40 percent at a cost of only $1 per infant. The findings are reported in the Aug. 16 issue of the journal Nature.

Pinaki Panigrahi, M.D., Ph.D., professor, epidemiology and pediatrics, Center for Global Health and Development, and his colleagues in the College of Public Health, led the international research team. The results reflect a culmination of 15 years of research and could seriously impact infant health worldwide.

The special mixture included a probiotic called Lactobacillus plantarum ATCC-202195 combined with fructo-oligosaccharide (FOS), an oral synbiotic preparation developed by Dr. Panigrahi.

Probiotics are live bacteria and yeasts that are good for your health, especially your digestive system. Synbiotics are combinations of probiotics with an FOS supplement that promotes growth and sustains colonization of the probiotic strain. FOS, naturally found in breast milk and such plants as onion, chicory, garlic, asparagus, banana, artichoke and others, is food for the probiotic bacteria.

Sepsis is a severe complication of bacterial infection that results in around one million infant deaths worldwide each year, mostly in developing countries. It occurs when the immune system stops fighting germs and begins to turn on itself and can lead to tissue damage, organ failure and death.

It is estimated that 40 percent of patients with severe in developing countries do not survive. When children and adults are included, the inpatient cost for managing patients with sepsis in U.S. hospitals is nearly $24 billion each year.

"This is the largest clinical trial of probiotics in newborns funded by the National Institutes of Health," Dr. Panigrahi said. The team enrolled more than 4,500 newborns from 149 villages in the Indian province of Odisha and followed them for their first 60 days, the most critical period when they get sick and die.

During their first days of life, the newborns were administered the oral preparation for seven days.

Results of the randomized, double-blind, placebo-controlled study showed that sepsis and deaths in the first two months of infancy were reduced by 40 percent, more than twice the anticipated reduction of 20 percent. The synbiotic treatment also lowered respiratory tract infections.

The effectiveness demonstrated in Dr. Panigrahi's study was so successful the study was halted early.

The probiotic formula could be a "very cheap oral sepsis vaccine," Dr. Panigrahi said.

Few trials on the use of probiotics to prevent sepsis have focused on newborns, whose largely naive immune system and less complex intestinal environment would allow the probiotic to grow.

"We were concerned when the data safety and monitoring board stopped the study prematurely. We had enrolled just about half of our proposed subjects. Typically, a study is stopped when something is wrong.

"But, it was a moment of superlative thrill when we learned it was stopped due to early efficacy. We were surprised a second time when the complete data analysis showed that also were reduced – something we did not anticipate in our population," Dr. Panigrahi said.

What's next?

A country's health is measured by its .

India has one of the highest rates of infant mortality in the world. Of the one million newborns who die at birth worldwide, India accounts for 700,000 such deaths, according to UNICEF. For every 1,000 live births in India, 40 babies die.

By comparison, the infant mortality rate in Sri Lanka, Nepal, and Bangladesh are 9, 29, and 33, respectively, according to the World Health Organization(WHO).

Dr. Panigrahi wants to bring these numbers down and the results of his study are a big first step.

"This study has to be replicated in different countries and under different circumstances. We maintained tight controls on the administration of the synbiotic and conducted a rigorous follow-up which will not be available in real life," he said.

"We have to find out why respiratory infections went down. How does this treatment affect the lungs?"

The intestinal system is the largest immune organ in the body, Dr. Panigrahi said. "If you took it apart and spread out the villi – small, finger-like projections that extend into the small intestine – it would cover a tennis court. And, it's loaded with lymphoid cells. So, if you want to stimulate the body's immunity, go to the intestine."

About sepsis

Also known as "blood infection," sepsis is a care problem that is more common than heart attack and claims more lives than any cancer. In the least developed countries, it is a leading cause of death.

In the developing world, sepsis accounts for 40 percent of all neonatal lives lost per year and more than 100,000 women contract sepsis in the course of pregnancy and childbirth.

In children and adults, sepsis occurs when the body's attempt to fight an infection results in the immune system damaging tissues and organs. This chaotic response, designed to protect us, causes widespread inflammation, leaky blood vessels and abnormal blood clotting resulting in organ damage. In severe cases, blood pressure drops, multiple organ failures ensue and the patient can die rapidly from septic shock.

Explore further: Protective association identified for asthma against sepsis

More information: Pinaki Panigrahi et al. A randomized synbiotic trial to prevent sepsis among infants in rural India, Nature (2017). DOI: 10.1038/nature23480

Related Stories

Protective association identified for asthma against sepsis

June 23, 2017
(HealthDay)—For patients with infections, those with asthma have reduced risk of sepsis, according to a letter to the editor published online May 22 in the American Journal of Respiratory and Critical Care Medicine.

Scientists illuminate role of staph toxins in bacterial sepsis

February 2, 2017
Staphylococcus epidermidis bacteria are a significant health concern for hospitalized infants, children and anyone with implanted medical devices. The bacteria—typically skin dwellers—can infect the bloodstream and cause ...

Recognize sepsis as a separate cause of illness and death

January 9, 2017
Sepsis should be recognized as a separate cause of illness and death around the world. This focus would help efforts to prevent sepsis by improving hygiene, nutrition and vaccination rates and also lead to timely treatment, ...

Readily available drug cocktail can help prevent sepsis shock and death

June 26, 2017
Sepsis presents a major challenge for health care providers, especially in low-income countries where the mortality rate can exceed 60 percent. Even in advanced medical settings, sepsis is still very dangerous and accounts ...

Confronted with sepsis, key immune mechanism breaks, scientists find

July 28, 2016
When the body encounters an infection, a molecular signaling system ramps up the body's infection-fighting system to produce more white blood cells to attack invading bacteria. Now researchers have discovered that when facing ...

Children who survive sepsis often experience lingering effects

May 4, 2017
Survival rates have risen dramatically in recent years among children who develop sepsis, a severe, life-threatening immune reaction to an infection somewhere in the body. But new research being presented at the 2017 Pediatric ...

Recommended for you

Early childhood interventions show mixed results on child development

April 24, 2018
Early childhood interventions may have some efficacy in boosting measures of child health and development in low income countries, but more work is needed to sort out how to implement these interventions, according to a new ...

New study shows prenatal cannabis use associated with low birth weights

April 23, 2018
With marijuana use during pregnancy on the rise, a new study led by the Colorado School of Public Health shows that prenatal cannabis use was associated with a 50 percent increased likelihood of low birth weight, setting ...

New research suggests possible link between sudden infant death syndrome and air pollution

April 20, 2018
A study led by the University of Birmingham suggests a possible association between exposure to certain pollutants and an increased risk of so-called 'cot death'.

Common antidepressants in pregnancy may alter fetal brain development

April 10, 2018
(HealthDay)—Pregnant women who take certain antidepressants may unknowingly compromise the brain development of their child, researchers suggest.

Kids in tough neighborhoods head to ER more often

April 6, 2018
(HealthDay)—Growing up in a disadvantaged neighborhood may mean more visits to the emergency room, a new study suggests.

Infant death study reveals dangerous sleep practices among babysitters, relatives, others

April 2, 2018
Babies who died during their sleep while being watched by someone other than parents often had been placed in unsafe sleep positions, such as on their stomachs, or in unsafe locations, such as a couch, a new study has found.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.