Could Probiotics Benefit Patients With Severe Burns?
Severe burn injuries appear to dramatically alter the 100 trillion bacteria inside the gastrointestinal tract, according to a new study. This novel insight suggests that targeting bacteria in the gut may help burn patients.
“We observed that burn injury significantly changes the normal gut microbiota,” says senior study author Mashkoor A. Choudhry, PhD, of the Burn & Shock Trauma Research Institute in the Loyola University Chicago Health Sciences Division. “We found that burn causes a significant increase in Enterobacteriaceae, a group of bacteria that has the potential to be harmful for the host.”
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Choudhry and his colleagues examined fecal samples from 4 severely burned patients who had been treated in the Burn Center of Loyola University Medical Center. The samples were taken 5 to 17 days after the burn injuries had occurred. Researchers compared the microbiomes of these patients with those of a control group of 8 patients who had suffered only minor burns.
They found that Enterobacteriaceae accounted for an average of 31.9% of bacteria in the gut microbiome in the severely burned patients, compared to just 0.5% in those who had suffered minor burns.
In addition to the dramatic rise in Enterobacteriaceae, a family that includes pathological bacteria such as E. coli and Salmonella, researchers noted a corresponding drop in the healthy bacteria that typically keep harmful bacteria in check. Such imbalances may contribute to sepsis or other infectious complications that cause 75% of all deaths in patients with severe burns, according to Choudhry.
He says multiple factors may account for the changes in the microbiome—ranging from inflammation in the gut to an altered defense mechanism against specific bacterial populations, but more research is needed to confirm these possibilities.
In future studies, Choudhry and his colleagues hope to address whether probiotics might be used to restore a healthy microbiome and reduce the risk of sepsis and other infectious complications in patients with severe burns or trauma.
“At this point, we do not know whether probiotics will work in burn injury,” he says. “In our study, we observed reductions in potentially protective bacteria after burn injury, so one potential possibility to overcome this is by reconstitution of these strains to determine if such treatment reestablishes the gut microbiota and reduces the risk of sepsis.”
He and his team are planning to expand their studies with a larger burn patient population to confirm their current observations and, for that, they will be approaching national funding agencies such as the National Institutes of Health to continue this study.
—Colleen Mullarkey
Reference
Earley Z, Akhtar S, Green S, Naqib A, Khan O, Cannon A, et al. Burn injury alters the intestinal microbiome and increases gut permeability and bacterial translocation. PLOS ONE. 8 July 2015. [Epub ahead of print]. DOI: 10.1371/journal.pone.0129996.