Telethon Kids researchers lead national trial to fight sepsis in premature infants

Telethon Kids Institute and Child and Adolescent Health Service researchers will lead a new national clinical trial (COSI-2) to determine whether topical coconut oil can reduce late onset sepsis in extremely preterm infants.

Professor Tobias Strunk, Co-Head of the Neonatal Infection and Immunity team at the Wesfarmers Centre of Vaccines and Infectious Diseases, based at the Telethon Kids Institute, and Child and Adolescent Health Service Neonatologist at King Edward Memorial Hospital, said if the trial is successful, application of coconut oil could become a standard part of the care of vulnerable premmies in high resource Neonatal Intensive Care Units (NICU).

"Almost 27,000 babies are born preterm each year in Australia. Survival has improved, but preterm births account for 75% of neonatal death and childhood disability. This is a lifetime burden borne by the family and the hospital system.

"In extremely preterm infants the skin is very immature and its integrity deteriorates quickly after birth. Those with the poorest skin condition end up with the highest incidence of sepsis. Despite this, we still don't have any routine intervention available to maintain skin integrity and prevent sepsis," said Professor Strunk.

Sepsis is a bloodstream infection that causes acute illness and can result in death. Late onset sepsis is one of the most frequent complications of babies born extremely preterm or under 28 weeks gestation with approximately 25% of these vulnerable infants suffering from it.

Infants who survive late onset sepsis are at greater risk of health complications, including disability. The majority of sepsis cases are caused by bacteria that colonise the skin within days of birth.

"The pilot study at King Edward Memorial Hospital showed that twice daily, gentle application of virgin coconut oil was easy to use, safe and that it improved skin condition.

"Importantly, it also offers an opportunity to actively engage parents in the care of their infant. Anecdotally, there were emotional and bonding benefits," said Professor Strunk.

Researchers found lower rates of sepsis among babies at KEMH NICU once coconut oil was introduced as regular care.

Funded by the US Thrasher Research Fund, the team is starting a large national trial to find out with certainty if coconut oil application to the skin can reduce preterm infant sepsis.

Professor Strunk said if our hypothesis is confirmed, this widely available, low-cost intervention could be translated rapidly into routine clinical care.