Fecal transplantation 'more effective than previously thought' for C. diff infection

Fecal transplantation for patients with Clostridium difficile infection may be a more effective treatment strategy than previously thought, according to a new study.

 

Conducted by researchers from your University of Minnesota and also the University of Colorado-Boulder, the investigation reveals that fecal transplantation makes long-term healthy changes on the gut bacteria of patients have been infected with C. difficile - a finding people say could have important regulatory implications for that procedure.

Study co-author Michael Sadowsky, with the Microbial and Plant Genomics Institute in the University of Minnesota, and colleagues publish their findings inside journal Microbiome.

C. difficile infections certainly are a major health concern within the US. According for the Centers for Disease Control and Prevention (CDC), the bacterium caused around half a million infections next year and killed around 29,000 people within 1 month of diagnosis.

C. difficile is shed in feces. Infection together with the bacterium may appear through hitting the ground with surfaces or items contaminated with feces. Infection with all the bacterium causes colon inflammation, referred to as colitis, resulted in fever, decrease of appetite, nausea, diarrhea and abdominal pain.

While many C. difficile infections can usually be treated with antibiotics, the issue can keep returning for some patients. In these cases, fecal microbiota transplantation (FMT) could be recommended.

FMT involves collecting the waste materials of a healthy donor, before purifying it and placing it in to the recipients' gut - normally via colonoscopy. It is thought to work by replacing the "friendly" gut bacteria that was wiped out through overpopulation of C. difficile.

However, Sadowsky and colleagues observe that, while past research has shown that the fecal microbiota of FMT patients is just like that in the donor, it's unclear to whether the alterations in gut bacteria due to FMT are long-lasting.
Patients' gut bacteria remained healthy for as much as 21 weeks after FMT

To uncover, the group enrolled four patients with recurrent C. difficile infection with their study, every one of whom were scheduled for FMT after treatment with antibiotics failed.

The researchers collected fecal samples through the patients both before FMT and daily for about 151 days following procedure.

The composition of bacteria in each fecal sample was assessed using high-throughout genome sequencing. Each pre- and post-FMT sample was compared. The samples were also weighed against those of 10 other patients with recurrent C. difficile infection, plus the sequences of each and every sample were in contrast to those of healthy people who were a part in the Human Microbiome Project.

In addition, the group assessed changes from the composition of gut bacteria after a while in both the fecal samples in the four patients and fecal samples through the donor.

The researchers found how the gut bacteria of patients who underwent FMT was normalized shortly following the procedure. They were surprised to seek out, however, that while the composition of patients' gut bacteria changed following FMT, it remained healthy for 21 weeks.

Commenting within the findings, Sadowsky says:

    "Our study signifies that there are both short- and long-term changes within the fecal microbiome following transplantation. The diversity and types of microbes present get into a cloud of possibilities represented by that regarding 'normal fecal microbiota.'

    While we have now many similarities in fecal microbiota amongst humans generally, you will find individual differences which make us all unique, such as the affect apparent gut functioning."

Because the US Food and Drug Administration (FDA) class fecal microbiota like a "drug," they would like to know the exact gut bacteria composition a result of FMT before it can be recommended as standard cure for C. difficile infection - besides those with recurrent forms.

But Sadowsky and colleagues state that because FMT generally seems to alter gut bacteria composition in an array of diversities deemed healthy, such requirements through the FDA will not be applicable on the procedure.

"We [...] conclude that this dynamic behavior of microbiota ought to be taken into account making comparisons between individuals, and really should become an important part of analysis in the success of FMT." they add.

Last month, an incident report published inside journal Open Infectious Diseases revealed what sort of woman became obese after undergoing FMT from an overweight donor.

And these days, a Spotlight feature from Medical News Today investigated the utilization of FMT for C. difficile infection and how the treatment is currently regulated.