Probiotic Bacteria Could Protect Newborns From Deadly Infection

Aug 16, 2017

If you're in desperate need for some good news, look no further.

Scientists in the U.S. and India have found an inexpensive treatment that could possibly save hundreds of thousands of newborns each year.

And it turns out, the secret weapon was sitting in Asian kitchens all along: probiotic bacteria that are common in kimchi, pickles and other fermented vegetables.

Feeding babies the microbes dramatically reduces the risk newborns will develop sepsis, scientists report Wednesday in the journal Nature.

Sepsis is a top killer of newborns worldwide. Each year more than 600,000 babies die of the blood infections, which can strike very quickly.

"All the sudden the baby stops being active. It stops crying and breastfeeding," says Dr. Pinaki Panigrahi, a pediatrician at the University of Nebraska Medical Center College of Public Health, who led the study.

"By the time the mother has a chance to bring the baby to the hospital, the baby dies," he says. "In hospitals in India, you see so many babies dying of sepsis, it breaks your heart."

For the past 20 years, Panigrahi has been working on a way to prevent sepsis.

Early on he thought probiotic bacteria might be the answer because they work well on another infection that affects preemies, called necrotizing enterocolitis. It damages the intestines.

The tricky part, Panigrahi says, was figuring out the best strain of bacteria to protect against sepsis.

"We screened more than 280 strains in preliminary animal and human studies," Panigrahi says. "So it was a very methodical process."

In the end, the one that seemed the most promising was a strain of Lactobacillus plantarum isolated from the diaper of a healthy Indian baby. So Panigrahi and his team decided to move forward with a large-scale study on thousands of babies in rural India.

They were shocked by how well the bacteria worked.

Babies who ate the microbes for a week — along with some sugars to feed the microbes — had a dramatic reduction in their risk of death and sepsis. They dropped by 40 percent, from 9 percent to 5.4 percent.

But that's not all. The probiotic also warded off several other types of infections, including those in the lungs. Respiratory infections dropped by about 30 percent.

"That was a big surprise, because we didn't think gut bacteria were going to work in a distant organ like the lung," Panigrahi says.

The treatment worked so well that the safety board for trial stopped the study early. "We were planning to enroll 8,000 babies, but stopped at just over 4,000 infants," Panigrahi says.

The only significant side effect seen in the study was abdominal distension, which occurred in six babies. But there were more cases reported in the placebo group than in the group that got the probiotic.

Panigrahi estimates a course of the probiotic costs about $1 per baby. "It can be manufactured in a very simple setting," Panigrahi says, "which makes it cheap."

Now if you think about what's going on here, it almost seems counterintuitive. Remember sepsis is a bacterial infection. So the researcher are preventing a bacterial infection with bacteria.

How is that possible? "Essentially these bacteria have a whole number of health benefits that we have just started to understand in the past couple of years, says Dr. Pascal Lavoie, a neonatologist at BC Children's Hospital in Vancouver, British Columbia.

First off, these beneficial bacteria can push out harmful bacteria in the baby's gut by changing the environment or simply using up resources, Lavoie says.

The probiotic bacteria also produces a compound that strengthens the wall of the intestine. "It acts as a barrier to prevent the bad bacteria from going through the wall into the blood," he says.

And, the probiotic bacteria can jump-start a baby's immune system.

"They can promote maturation of the immune system in a healthier way," Lavoie says. "Probiotics can be much more powerful than drugs."

But like drugs, they need to be fully tested before they become routine in maternity wards around the world, Lavoie says. That means testing the probiotic in more locations and on babies who have the highest risk for sepsis — those born prematurely or underweight.

"Sepsis is such a important problem around the world," Lavoie says. "This study has huge potential."

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ROBERT SIEGEL, HOST:

Now some good news, especially for babies around the world. Scientists in the U.S. and India have found an inexpensive treatment for a common infection. It could save hundreds of thousands of newborns each year. The treatment comes from a surprising source - bacteria found in fermented foods. As NPR's Michaeleen Doucleff reports, the bacteria helped babies in a clinical trial so much, researchers stopped the trial early.

MICHAELEEN DOUCLEFF, BYLINE: The top killer of newborns around the world is a deadly blood infection called sepsis. Dr. Panaki Panigrahi at the University of Nebraska Medical Center says sepsis can strike babies just a few days after they're born. And it happens fast.

PANAKI PANIGRAHI: That is the problem. They die so quickly.

DOUCLEFF: The baby seems fine, healthy. And then all of a sudden, it stops crying, stops breastfeeding. A few hours later, the baby is really sick.

PANIGRAHI: And by the time the mother has a chance to bring the baby to either the hospital or any kind of a health care facility, the baby dies.

DOUCLEFF: Each year, sepsis kills more than 600,000 newborns. That's more than 1,600 babies every day. Panigrahi says when you're at a hospital in India, it's overwhelming how many babies suffer from sepsis.

PANIGRAHI: You see so many are dying, or all of them are dying - kind of breaks your heart.

DOUCLEFF: So Panigrahi has dedicated his career to finding a way to prevent sepsis, to stop it before it happens. And now he has huge results.

PANIGRAHI: It has taken me about 20 years to get to this point.

DOUCLEFF: Panigrahi and his team report in the journal Nature that common bacteria can prevent sepsis in newborns - turns out the critters were sitting in our kitchen the whole time. The bacteria are called Lactobacillus plantarum, and they're used to make kimchi, pickles and fermented radishes. So you could literally grow this treatment in your kitchen.

PANIGRAHI: It can be manufactured in a very simple setting. And because of that, it is cheap.

DOUCLEFF: He estimates it costs about a dollar per baby. When babies eat the probiotic for about a week, it reduces the risk of death by 40 percent - from 9 percent to 5 percent. But that's not all. The probiotic also warded off several other infections, including those in the lungs.

PANIGRAHI: So that was a big surprise because we didn't think that it is going to work in a distant organ like lungs.

DOUCLEFF: OK. Now, if you think about what's going on here, it almost sounds counterintuitive. Sepsis is a bacterial infection. So the researchers are preventing a bacterial infection with bacteria. How is that possible? Well, Dr. Pacsal Lavoie studies babies' immune systems at BC Children's Hospital in Vancouver. He says these good bacteria sort of push out bad bacteria in the baby's gut. They also jump-start the immune system.

PASCAL LAVOIE: They would also promote maturation of the immune system of the baby in a healthier way.

DOUCLEFF: And the bacteria produce a compound that strengthens the wall of the intestine.

LAVOIE: It acts as a barrier or a wall that prevent the bad bacteria from going through.

DOUCLEFF: So these good bacteria are actually pretty powerful.

LAVOIE: Yes. And in a way, it's much more powerful than any drugs.

DOUCLEFF: But like drugs, the probiotic needs to be fully tested before it's used around the world. Lavoie says that means testing it in more places and on babies at highest risk for sepsis - those born prematurely or underweight. Michaeleen Doucleff, NPR News.

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