Antibiotics may not be enough to prevent deadly infections in critically ill patients.
A recent study from the University of Calgary has suggested that maintaining a healthy microbiome may help prevent life-threatening infections in critically ill individuals. The research delves into the relationship between the immune system and the human gut.
The study highlights the concerning statistic that up to 50% of all critically ill patients acquire potentially fatal infections while in the intensive care unit or during hospitalization after their ICU stay. These infections significantly increase the risk of mortality.
According to Dr. Braedon McDonald, MD, PhD, an intensive care physician at the Foothills Medical Centre (FMC) and assistant professor at the Cumming School of Medicine (CSM), hospital-acquired infections continue to pose a significant clinical challenge despite the use of antibiotics.
“We don’t have good solutions,” he comments.
The study took a unique approach to tackle this issue, examining the body’s natural defense mechanism against infections in order to better understand why some individuals are more prone to contracting deadly infections.
During the study, 51 newly admitted patients to the intensive care unit (ICU) at Foothills Medical Centre were observed during the first week of their acute critical illness. The research unveiled a dynamic “metasystem” in which the gut microbiota and systemic immunity work in tandem. The study revealed that when issues arise with gut microbes and immune system dysfunction, there is a significant increase in the rates of hospital-acquired infections.
Jared Schlechte, a PhD candidate in Dr. Braedon McDonald’s lab and the first author of the study, explained that the findings suggest a family of gut bacteria plays a vital role in directing the immune system. However, during critical illness, the microbiome becomes compromised, allowing harmful bacteria to flourish.
The research, which was published in Nature Medicine, revealed that patients who exhibited abnormal growth of a common bacteria, referred to as a “bloom,” were at the greatest risk of experiencing severe infections.
Dr. Braedon McDonald believes that this discovery is a significant breakthrough, as it provides a new approach to not only treating infections but also potentially preventing them. He explains that the findings suggest that fighting infections cannot be achieved by solely targeting harmful bacteria or solely focusing on the immune system. Rather, a holistic approach that takes into account the functioning of both systems is essential.
Moving forward, Dr. Braedon McDonald and his team intend to launch a randomized, controlled clinical trial. The trial will utilize a precision medicine approach inspired by probiotics therapy, utilizing multiple engineered bacteria specifically designed to target the harmful bacteria identified in the study. Participants who consent to the study will receive engineered microbiomes.
Dr. McDonald explains that “What we’re trying to do is restore the normal mechanism that work when we’re healthy, and take advantage of that to help protect people from infections.”
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