Bacteria that play dirty require a dirty solution: Fecal transplants help drive out life-threatening intestinal infection

Fecal transplants could be the answer to treating one of the most common life-threatening intestinal infections. A new study from researchers at Aarhus University finds that using fecal transplants are an effective cure for people infected with the bacteria Clostridioides difficile (C. difficile)

“Our new study shows that we can effectively cure the infection through the early use of feecal microbiota transplantation (FMT) after completing the standard treatment, to prevent relapses,” says Simon Mark Dahl Bauwall, a PhD student and doctor at Aarhus University Hospital, in a statement.

C. difficile infects hundreds of thousands of people every year and is responsible for thousands of death. Its deadliness is most apparent among older adults or people with immunocompromised states. The standard treatment for a C. difficile infection is antibiotics, but that is only partially effective and the infection may reemerge again.

Currently, fecal transplants are only available to people with the most stubborn C. diff cases where the infection does not respond to conventional treatment methods. There are only three infections that qualify.

In the study, the team expanded the number of eligible participants to 42, where half received the transplant and the other half received a placebo. The results suggest most patients were cured of the bacterial infection after receiving fecal transplantation.

Fecal transplants work by transferring the feces of healthy donors, which is swarming with a complex microbial ecosystem, to people with intestinal disorders. “We found that treatment with FMT after completing the standard treatment cured 19 out of 21 patients, whereas only seven out of 21 treated with a placebo or another antibiotic were cured. In other words, the probability of curing the infection is three times greater after treatment with FMT than with our current standard treatment alone,” explains Baunwall.

Because the fecal transplant worked on most of the participants, they had to stop the study for ethical reasons and offer the treatment to the placebo group. “In rare cases, it can happen that you discover that the treatment you are investigating is so effective that it is ethically indefensible to continue,” says Baunwall. “Our study is one example, in that the new FMT treatment is so much better than the standard treatment with antibiotics that it would be unethical to continue, because the patients in the control group would risk not receiving the FMT treatment.”

Stopping C. difficile infections is only one potential way fecal transplants can improve human health. The research authors note scientists are testing out this unorthodox method for other diseases that alter the gut microbiome. “At the moment, many studies of FMT treatment for various diseases are being carried out worldwide, with the most promising of these indicating beneficial effects in patients with inflammatory bowel disease and multi-resistant bacteria,” explains Baunwall.

The study is published in The Lancet Gastroenterology & Hepatology.

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