More Evidence That Fecal Transplant Is Effective Against C difficile

Clostridium difficile infections are being treated successfully with fecal microbiota transplantation, studies show. (Image: ©AMA)

A new study adds to growing evidence that a procedure known as fecal microbiota transplantation (FMT) is an effective, fast-acting treatment for potentially deadly Clostridium difficile infection.

Researchers presented data today at the annual Infectious Diseases Society of America meeting in San Diego that followed up 49 patients with C difficile infection for 3 months after they were treated with FMT. Of the 49 patients, 43 recovered fully, 4 died of causes not related to their infection, 1 required intestinal surgery, and 1 did not improve.

“More than 90 percent of the patients in our study were cured of their C diff infection,” lead author Mayur Ramesh, MD, said in a statement. “This treatment is a viable option for patients who are not responding to conventional treatment and who want to avoid surgery.”

Patients taking antibiotics are vulnerable to intestinal infection because the drugs disrupt bacteria that naturally live in the colon. C difficile produces toxins that can cause watery diarrhea, fever, loss of appetite, nausea, and abdominal pain and tenderness. In severe cases, toxins attack the lining of the colon, and surgery may be needed to remove infected tissue. About 14 000 US deaths a year are C difficile–related.

Despite seeming counterintuitive, C difficile symptoms often are treated with an antibiotic, usually metronidazole or vancomycin. But researchers have sought other treatments because infection rates have increased dramatically over the past decade, recurrence rates are high, and the bacterium is resistant to many antibiotics.

Fecal microbiota transplantation was introduced as an effective treatment more than 50 years ago but never came into wide use. The procedure consists of taking stool from a healthy donor, often a family member, and transplanting it into patients via colonoscopy or a nasogastric tube. Ramesh, an infectious diseases physician at Henry Ford Hospital in Detroit, said patients can’t smell or taste the transplanted material when it’s delivered through a nasogastric tube.

Earlier this year, several studies reported that FMT is safe and effective in treating C difficile infection. Study populations have been small, but one reported a primary cure rate of 91% and another showed that FMT was 92% effective in preventing recurrences for up to 11 months.

Categories: Bacterial Infections, Infectious Diseases, Public Health