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Fatal sepsis may be more likely in some patients due to gastrointestinal problems.
Researchers from the Korea Research Institute of Bioscience and Biotechnology’s Infectious Disease Research Center used female mouse models to investigate why the effects of sepsis can be so different.
The study, published in the journal Nature, looked at genetically identical mice with different gut microbiomes. Mice infected with Acinetobacter baumannii – a resistant bacterium that can lead to sepsis.
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The researchers compared groups of mice with high and low survival rates, examining differences in their gut microbiomes, the number of bacteria in their blood and organs, and other cellular markers, according to the study’s press release.
Gut health may indicate severe sepsis before infection, research suggests. (Stock)
Risk measures
Although the rest of the mice were genetically identical, the most susceptible mice had a higher concentration of Muribaculaceae bacteria in their gut. In one comparison, these bacteria made up about 28% of the microbiome in the poorer surviving mice, but only 0.15% in the better surviving mice.
The mice that survived the worst showed an early and strong inflammatory response, which led to an increase in bacteria in the blood, lungs and spleen. This suggests that the microbiome causes the immune system to become more active, according to the researchers.
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In the microbiome of the mice with the worst survival, the researchers also noticed that one type of bacteria – Sangeribacter muris KT1-3 – was very prominent. Mice that normally survived at high rates became worse when housed with KTI-3 mice, their survival dropping to 10%.
High-risk mice had higher concentrations of Muribaculaceae bacteria in the gut. (Stock)
This type of bacteria has also been shown to make inflammation worse during certain infections, making sepsis more severe.
These findings suggest that the gut microbiome can signal how the immune system will respond before infection begins.
The incredible influence of the microbiome
Andrew Fleming, MD, chief of the division of Infectious Diseases & Immunology at NYU Langone Hospital, Brooklyn, said it has been “known for years” that intestinal bacteria and bacterial toxins can be released into the bloodstream during sepsis.
This worsens the inflammatory response to the initial infection, according to Fleming, who was not involved in the study.
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“This process is particularly important in septic shock, where the intestinal wall is susceptible to the transfer (or leakage) of bacterial products,” Fleming said.
The interaction between the gut microbiome and the immune system is “complex and varies from person to person,” the doctor explained.
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“But there is growing evidence that a diverse and healthy gut microbiome – the community of bacteria that live in the human gut – is somewhat protective against severe sepsis,” he continued. “And a dysfunctional microbiome – for example, one that is greatly altered by antibiotics – can damage or make the immune response worse during sepsis.”
The interaction between the gut microbiome and the immune system is “complex and varies from person to person,” the doctor explained. (Stock)
Scientists are beginning to think of the gut microbiome “almost like a living organ,” according to Fleming, similar to the heart, kidneys or liver, all serving “multiple functions” to keep the body healthy.
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An unhealthy microbiome can have “detrimental effects on many health problems,” he added — including how the body responds to disease.
“Compared to our other organs, we currently have few tests readily available in the doctor’s office to measure the health of our microbiome,” Fleming said. “However, this should not prevent us from thinking about our gut microbiome and how we can keep it healthy.”
The role of antibiotics
Antibiotic use has “major and long-lasting effects” on the microbiome, notes Fleming. Up to 80% of adults in the US are prescribed an antibiotic each year, and an estimated 30% don’t need it, according to the CDC.
“Antibiotics destroy the diversity of the microbiome and create a void in the microbial community that can be filled by harmful bacteria from nature,” the doctor told Fox News Digital.
Antibiotics “destroy the diversity of the microbiome and create a void in the gut microbial community that can be filled by harmful bacteria from nature,” the doctor said. (Stock)
“We have to start thinking seriously about our antibiotic use and overuse, in order to preserve our gut health and reduce the spread of antibiotic resistance.”
The study’s findings are “an interesting starting point for further research,” Fleming said, although there were some important limitations.
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“Sangeribacter muris is not normally found in humans, so the exact mechanism of this severe bacterial sepsis shown in this study cannot be directly extrapolated to humans,” he said. “Well-designed clinical trials should be conducted to test how similar effects of the gut microbiome may play in sepsis in humans.”
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Despite these limitations, the doctor said he supports the idea that maintaining a healthy gut microbiome can help keep the immune system in good control while reducing the risk of developing severe sepsis.
