Ruminations

Bacterial Safeguards

"[The study] is an absolute game-changer."
"There's nothing we have like this in our armamentarium to prevent infections in newborns. Also, there's how cheap it is, its ease of use -- it's oral -- and its independence of pharmaceutical companies and their patent issues."
Dr. Tobias R. Kollmann, pediatric immunologist, University of British Columbia

Matt Twombly for NPR

The journal Nature published the results of a large clinical trial in rural India recently, whose findings have hugely impressed the medical world of child medicine. A condition caused by chronic malnutrition and diarrhea -- lethal sepsis -- was found to be responsive to a new probiotic treatment pioneered by Dr. Pinaki Panigrahi, a pediatrician at the University of Nebraska Medical Center's Child Health Research Institute.

Sepsis, a life-threatening bloodstream infection, is the cause of death of 600,000 newborn babies every year. The clinical trial took place in rural India, feeding babies a special strain of Lactobacillus bacteria. In the controlled study, after one week of treatment the babies receiving the probiotic responded so amazingly well -- 40 percent less likely to develop sepsis -- that it was considered to be immoral to continue the study with the children who were chosen to receive a placebo, not sharing in the obvious advantages of the treatment.

A treatment that proved so immediately to be so exceedingly successful that the babies given the probiotic -- costing a mere $1 -- were found to have fewer bouts of pneumonia, of diarrhea, fewer ear infections, as well as infections of the umbilical cord stump. The takeaway from this swiftly-rewarding protocol was that probiotics individually chosen, could also be useful in helping to prevent stunting, a condition afflicting 160 million of the globe's children.

Caused by chronic malnutrition and diarrhea, stunting confoundedly persists even in conditions that see children fed sufficient food, leaving experts to believe that it is a lack of needed bacteria to absorb nutrients that is responsible. The purpose of probiotic supplements is to have the gut colonized with beneficial bacteria with a view to preventing harmful strains from gaining the upper hand. But Dr. Panigrahi cautions that probiotics are required to be precisely matched to the illness for which they are prescribed.

Selecting an incorrect bacteria for an ill baby could be the cause of that child's death.

Dr. Panigrahi's research team tested 280 different strains of bacteria over a decade, searching for one that would attach to the gut, not enter the bloodstream, and be capable of outgrowing harmful bacteria. The samples examined from Indian yogurts of health food shops proved to be useless. But sample No. ATCC-202195 of Lactobacillus plantarum was derived from a healthy 11-month-old child in Maryland, and it provided the answer the researchers were looking for.

Funded by the National Institutes of Health in America, Dr. Panigrahi's successful work will enable him to extend testing to premature and sickly infants in greatest danger of contracting sepsis. As well, in some parts of the world, stunting leaves about half of the children living there of lesser proportions than they should attain to, leaving them as well to suffer from lifelong learning difficulties.