Fecal transplants could potentially protect newborns who received antibiotics that killed “good” gut bacteria. Researchers from Cincinnati Children’s Hospital Medical Center led the charge on the study.
According to the study, some half-a-million newborns annually in the United States are being exposed to immune-disrupting antibiotics.
In the latest study, Cincinnati Children compared animals who were exposed to antibiotics as newborns and later exposed to bacteria known to trigger severe pneumonia to animals that were not exposed to early antibiotic treatment.
Researchers found that all the animals who were antibiotic-disrupted suffered severe symptoms within 60 hours, while those with undisrupted immune systems avoided critical symptoms.
The researchers found a host of disruptions caused by antibiotic exposure in both the amount and structure of immune cells called neutrophils, which are found in the blood and in lung tissue. Other damaged immune cell types included T-cells, alveolar macrophages and interstitial macrophages. These changes produced a hyper inflammatory response in the lungs to infection among the antibiotic-exposed newborns.
“The body moves quickly after birth to fully establish the lung’s immune protection system,” says Dr. Hitesh Deshmukh, Cincinnati Children’s neonatologist and immunology expert, in a statement. “Failure to restore healthy gut microbiota before that development window closes can result in infants growing up with lungs that are permanently less able to respond to infections later in life.”
Researchers say that the damage antibiotics did to commensal microbiota can be restored by a fecal transplant that can supply healthy bacteria to the intestines of a child that lacks them. The fecal transplant fully restored commensal bacteria to normal pre-exposure levels in some animals that had early antibiotic damage, but only partially in others. The animals who had restored and partially restored microbiota developed strong immune systems in their lungs and were better able to resist the pneumonia-causing infection “challenge.”
About one in four pregnant women carry Group B streptococcus in their bodies without showing symptoms. This type of bacteria can cause sepsis, pneumonia and meningitis in newborns.
“It is not possible to completely discontinue the use of antibiotics in newborns. In certain cases, antibiotics are the only way to prevent death from infections like Group B Streptococcus,” says Deshmukh. “However, this paper shows why antibiotic use must be kept to the absolute minimum and why it’s important to compensate for that usage as soon as possible.”
Fecal transplants are being studied in several clinical trials nationally. Cincinnati Children’s is not performing fecal transplants for healthy newborns, even in clinical trials.
The study is published in Science Translational Medicine.