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Fecal bacteriotherapy, or ‘stool transplant’ – infusing donor stool into the intestine of the recipient to re-establish normal bacterial microbiota – has shown promising results in preliminary studies but concerns about pathogen transmission, patient acceptance and inability to standardize the treatment regimen remain. Unfortunately, few effective treatments exist for those patients with multiple recurrences of CDI, a debilitating disease.
An association has been made between recurrent disease and intestinal dysbiosis, and an inability of certain individuals to re-establish their normal intestinal bacteria is thought to play a leading role in recurrence. Recurrent CDI is defined as complete resolution of CDI while on appropriate therapy followed by recurrence of CDI after treatment has been stopped. Recommended therapy for CDI consists of either metronidazole or oral vancomycin. The infection occurs most commonly when patients receive antibiotics that alter their normal enteric gut bacteria, allowing overgrowth of C. CDI accounts for 15 to 25% of antibiotic-associated diarrhea. difficile, a toxin-producing, Gram-positive, anaerobic, spore-forming bacillus.
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Trial registrationĬlinical trial registration number: NCT01372943Ĭlostridium difficile infection (CDI) is a bacterial disease of the gastrointestinal tract caused by C. This benefit correlates with major changes in stool microbial profile and these changes reflect isolates from the synthetic mixture.
This proof-of-principle study demonstrates that a stool substitute mixture comprising a multi-species community of bacteria is capable of curing antibiotic-resistant C. The analysis demonstrated that rRNA sequences found in the stool substitute were rare in the pre-treatment stool samples but constituted over 25% of the sequences up to 6 months after treatment. Following stool substitute treatment, each patient reverted to their normal bowel pattern within 2 to 3 days and remained symptom-free at 6 months. Resultsīoth patients were infected with the hyper virulent C.
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Pre-treatment and post-treatment stool samples were analyzed by 16 S rRNA gene sequencing using the Ion Torrent platform. Two patients who had failed at least three courses of metronidazole or vancomycin underwent colonoscopy and the mixture was infused throughout the right and mid colon. Thirty-three isolates were recovered from a healthy donor stool sample. difficile infection that had failed repeated standard antibiotics. Here we describe the use of a stool substitute preparation, made from purified intestinal bacterial cultures derived from a single healthy donor, to treat recurrent C. Fecal bacteriotherapy (‘stool transplant’) can be effective in treating recurrent Clostridium difficile infection, but concerns of donor infection transmission and patient acceptance limit its use.
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