Maternal Antibodies and Neonatal Protection from E. coli Sepsis

In a recent study published in Nature, lower maternally transferred anti–E. coli antibodies at birth were observed among infants who later developed severe infection.

Investigators retrieved archived dried blood specimens collected for routine newborn screening blood spots and compared antibody levels at birth between infants who later developed E. coli infection and infants who did not. The report described a case group of 100 babies with subsequent E. coli infection and a control group of 296 matched infants without infection, with some analyses comparing each case to the average of matched controls.

In the human sample analysis, antibodies targeting E. coli were described as lower in infants who developed E. coli infection than in controls. To address variability among E. coli isolates, the authors evaluated antibody levels using a pooled panel of neonatal sepsis clinical isolates, and the same pattern was observed in this assay. Overall, the case-control comparison linked lower newborn anti–E. coli antibody levels with later neonatal E. coli sepsis.

Alongside the human comparisons, the authors described mouse experiments designed to test whether maternal exposure could shape offspring protection. In that work, introducing the probiotic strain Escherichia coli Nissle 1917 to mice before pregnancy was reported to stimulate production of antibodies that protected newborn mice in experimental infection models.

Looking ahead, the authors said they plan to pursue development of a newborn risk screening test intended to identify newborns at highest risk of severe E. coli infection, and they also described investigating maternal interventions aimed at increasing protective antibodies, including a maternal probiotic approach.