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Cot death 'linked to bacterial infection'

30/05/2008

High levels of bacteria could be part of the cause of cot death, or sudden infant death (SID), UK researchers have suggested.

SID is one of the most common forms of neonatal death in the UK and there are many theories as to why it occurs.

Researchers at London's Great Ormond Street Hospital argue in the Lancet journal bacteria could be behind a proportion of unexplained SID and say the mechanism for his should now be studied.

They reviewed autopsies done at the hospital between 1996 and 2005 of 470 infants (aged seven days to one year) who died suddenly and unexpectedly.

Bacterial samples – cultures - were studied from each baby.

Significantly more cultures from infants whose deaths were unexplained contained Staphylococcus aureus bacteria (16 per cent) or E coli bacteria (93/1628, six per cent) than did those from infants whose deaths were of non-infective cause (S aureus nine per cent; E coli one per cent).

The researchers say these differences suggest that infection with these bacteria could be associated with unexplained cases of sudden, unexpected death in infancy (SUDI).

"We found that significantly more organisms that were potentially pathogenic were isolated from infants whose sudden, unexpected death could not be explained than from infants whose death was of non-infective cause," they conclude.

"Although the reasons for this are unclear, our findings suggest that microbes or microbial products could be related to the pathogenesis of a proportion of unexplained SUDI. We must now investigate the pathophysiological mechanism involved in these cases."

In an accompanying comment, Dr James Morris and Dr Linda Harrison from the Royal Infirmary, Lancaster, write: "Recent evidence indicates that death in explained SUDI is often rapid, with transition from being well to death in less than one hour in many cases.

"If bacteria have a role, this points to direct action of bacterial toxins on cardiorespiratory or neural control. The new science of proteomics offers techniques to recognise bacterial protein products in human body fluids, and this is the obvious next step in investigating sudden infant death."