The Effect of Pomegranate Extract on Survival and Peritoneal Bacterial Load in Cecal Ligation and Perforation Model of Sepsis in Rats

Background: Sepsis is one of the major causes of death in intensive care units. Oxidative stress and hyper‑inflammation has been shown to be major cause of mortality and morbidity in septic cases. Pomegranate is a fruit considered for its antioxidant and anti‑inflammatory properties. The aim of this study is to evaluate the effect of a standard pomegranate fruit liquid extract (POMx), on mortality and peritoneal bacterial load in cecal ligation and perforation (CLP) sepsis model. Methods: Male wistar rats were divided into four groups of 24 each: sham; CLP; prevention (consumed POMx [250 mg of polyphenols/ kg/day] for 4 weeks before CLP); treatment (received a single drink of POMx [250 mg of polyphenols/kg] after CLP). Each group was divided into three subgroups, each containing eight animals, for bacterial load and survival (with and without antibiotics) studies. Sepsis was induced by CLP surgery. Ten day survival rate was recorded. Peritoneal bacterial load was also assessed. Data were analyzed using Log‑rank and Kruskal‑Wallis tests. Results: There was no significant difference in survival rate of CLP, prevention and treatment groups, in subgroups without antibiotics. However, in subgroups with antibiotics, the prevention group had significantly lower survival rate than sham group (P<0.05). Conversely, the bacterial load of prevention and treatment groups were significantly higher than sham group (P < 0.01). Conclusions: Our study demonstrates for the first time that pomegranate extract could increase mortality rate via increasing peritoneal cavity bacterial load, in CLP sepsis model. More studies to assess mechanisms of this effect are warranted.