Tag Archives: fecal-bacteriotherapy

Scientific research demonstrates new evidence supporting Fecal Microbiota Transplant successful in treating C. difficile infections

Research published in the open access journal Microbiome offers new evidence for the success of fecal microbial transplantation (FMT) in treating severe Clostridium difficile infection (CDI), a growing problem worldwide that leads to thousands of fatalities every year.

Research led by Michael Sadowsky, Alex Khoruts, and colleagues at the University of Minnesota in collaboration with the Rob Knight Lab at the University of Colorado, Boulder, reveals that healthy changes to a patient’s microbiome are sustained for up to 21 weeks after transplant, and has implications for the regulation of the treatment. Findings also demonstrate the dynamic nature of fecal microbiota in FMT donors and recipients.

In FMT, fecal matter is collected from a donor, purified, mixed with a saline solution and placed in a patient, usually by colonoscopy. In contrast to standard antibiotic therapies                                (e.g., Vancomycin)  which further disrupt intestinal microflora and may contribute to the recurrence of CDI, FMT restores the intestinal microbiome and healthy gut function.

Using DNA samples of healthy individuals from the Human Microbiome Project (HMP) as a baseline, Sadowsky and his team compared changes in fecal microbial communities of recipients over time to the changes observed within samples from the donor. Significantly, the composition of gut microbes in the both donor and recipient groups varied over the course of the study, but remained within the normal range when compared to hundreds of samples collected by the HMP.

According to Sadowsky, the findings have important implications for a range of diseases associated with microbial imbalance, or dysbiosis, and could influence the regulatory regime surrounding FMT, currently treated as a drug by the U.S. Food and Drug Administration (USFDA).

“The dynamic nature of fecal microbiota in both the donor and recipients suggests that the current framework of regulation, requiring consistent composition, may need to be reexamined for fecal transplantations,” says Michael Sadowsky. “Change in fecal microbial composition is consistent with normal responsiveness to shifts in the diet and other environment factors. Variability should be taken into account when comparing microbial composition in normal individuals to those with dysbiosis characteristic of disease states, especially when assessing clinical interventions and outcomes.

Also discovered in the research, the performance of frozen and fresh preparations of fecal material was indistinguishable. Though the sample was limited and warrants further study with a larger cohort, it has several implications for the widespread adoption of FMT. The frozen preparation greatly simplifies the standardization and distribution of the fecal material. It also facilitates long-term storage of donor material for future study and makes FMT accessible to a greater number of physicians and patients. Finally, it offers advantages over fresh material in the testing of fecal samples for pathogens, which in some cases can take several weeks to complete.

While FMT is particularly successful in patients who suffer from recurrent CDI, University of Minnesota researchers led by Sadowsky and Dr. Alex Khoruts are currently preparing for a clinical trial using FMT to improve insulin sensitivity in pre-diabetic patients and to treat metabolic syndrome.

 

To read the article in its entirety please click on the following link:

http://www.eurekalert.org/pub_releases/2015-04/uom-nes040915.php

Fecal Microbiota Transplant – Study Provides Insight Into Structural/Metabolic Changes That Occur After FMT

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Fecal microbiota transplantation

The process of delivering stool bacteria from a healthy donor to a patient suffering from intestinal infection with the bacterium Clostridium difficile  works by restoring healthy bacteria and functioning to the recipient’s gut, according to a study published this week in mBio®, the online open-access journal of the American Society for Microbiology.

The study provides insight into the structural and potential metabolic changes that occur following fecal transplant, says senior author Vincent B. Young, MD, PhD, an associate professor in the Department of Internal Medicine/Infectious Diseases and the Department of Microbiology & Immunology at the University of Michigan in Ann Arbor. The transplants, which have been successful at curing more than 90 percent of recipients, have been used successfully since the 1950s, he says, though it hasn’t been clear how they work to recover gut function.

“The bottom line is fecal transplants work, and not by just supplying a missing bug but a missing function being carried out by multiple organisms in the transplanted feces,” Young says. “By restoring this function, C. difficile isn’t allowed to grow unchecked, and the whole ecosystem is able to recover.”

Young and colleagues used DNA sequencing to study the composition and structure of fecal microbiota (bacteria) in stool samples from 14 patients before and two to four weeks after fecal transplant. In 10 of the patients, researchers also compared stool samples before and after transplant to samples from their donors.

All transplant patients, treated at the Essentia Health Duluth Clinic in Minnesota, had a history of at least two recurrent C. difficile infections following an initial infection and failed antibiotic therapy.

Studying families of bacteria in the samples, investigators found marked differences among donor, pre-transplant and post-transplant samples. However, those from the donors and post-transplant patients were most similar to each other, indicating that the transplants at least partially returned a diverse community of healthy gut bacteria to the recipients. While not as robust as their donors, the bacterial communities in patients after transplant showed a reduced amount of Proteobacteria, which include a variety of infectious agents, and an increased amount of Firmicutes and Bacteroidetes bacteria typically found in healthy individuals, compared to their pre-transplant status.

Then, using a predictive software tool, researchers analyzed the relationship between the community structure of the micoorganisms and their function, presumably involved in maintaining resistance against CDI.

They identified 75 metabolic/functional pathways prevalent in the samples. The samples taken from patients before transplant had decreased levels of several modules related to basic metabolism and production of chemicals like amino acids and carbohydrates, but were enriched in pathways associated with stress response, compared to donor samples or post-transplant samples.

CDI has significantly increased during the past decade, Young says, with previous studies estimating there are more than 500,000 cases of CDI in the United States annually, with health care costs ranging from $1.3 billion to $3.4 billion. Up to 40 percent of patients suffer from recurrence of disease following standard antibiotic treatment. In a healthy person, gut microorganisms limit infections but antibiotics are believed to disrupt the normal structure of these microoganisms, rendering the gut less able to prevent infection with C. difficile.

Further identification of the specific microorganisms and functions that promote resistance of bacterial colonization, or growth, may aid in the development of improved CDI treatments, Young says: “If we can understand the functions that are missing, we can identify supplemental bacteria or chemicals that could be given therapeutically to help restore proper gut function.”

For article in its entirety click on the link below:

http://www.eurekalert.org/pub_releases/2014-06/asfm-ftr061214.php

 

The study was supported by the National Institutes of Health, the Michigan Gastrointestinal Peptide Research Center, and the Essentia Health Foundation in Duluth, Minn.

mBio® is an open access online journal published by the American Society for Microbiology to make microbiology research broadly accessible. The focus of the journal is on rapid publication of cutting-edge research spanning the entire spectrum of microbiology and related fields. It can be found online at http://mbio.asm.org.

The American Society for Microbiology is the largest single life science society, composed of over 39,000 scientists and health professionals. ASM’s mission is to advance the microbiological sciences as a vehicle for understanding life processes and to apply and communicate this knowledge for the improvement of health and environmental and economic well-being worldwide.

 

American Gastroenterological Association (AGA) for Fecal Microbiota Transplantation Information

The American Gastroenterological Association (AGA) provides information to both physicians, and patients regarding  fecal microbiota transplantation (FMT).

Visit the AGA FMT website: http://fmt.gastro.org for more detailed information.

Fecal Transplant Pill Introduced

Clearly a true innovative treatment for the recurrence of C. diff.. During IDWeek 2013, taking place in San Francisco, California, Canadian authors presented the new study and first formal success of fecal transplant pills treating the recurrence of C. diff. infections.

Dr. Thomas Louie, an infectious disease expert from the University of Calgary, found a way to package donated stool into vitamin-sized capsules used to repopulate the intestines of C. diff sufferers with beneficial bacteria. Dr. Louie has treated 27 patients and none had a recurrence of C. diff, even though all of them had had at least four bouts of the infection, which can lead to severe disease or death.

Quoted from the article:
Fecal transplant experts at the University of Minnesota have had some success with freezing fresh stool, and some suggest that freeze-drying the organisms might be a way to preserve it for wider use. Dr. Cliff McDonald, a C. diff expert at the CDC, said Louie’s work represents further innovation in the potentially life-saving treatment for the infections. “The idea has been held by a few for a number of years, but no one else I am aware of is actually doing it this way other than Dr. Louie,” he said.

Dr. Colleen Kraft, who performs fecal transplants at the Emory University School of Medicine, agreed.
“This is clearly the future of fecal transplant therapy,” she told NBC News. “And there are many poised in the market to support this type of therapy and related synthetic bacteriotherapy. I do not see any drawbacks if it is indeed efficacious.”

To read this article in its entirety please click on the link below:

http://www.nbcnews.com/health/poop-pills-are-latest-way-cure-dangerous-c-diff-infections-8C11300066

C. diff. infection, Fecal Microbiota Transplantation (FMT): an Introduction

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This is the first part “Introduction”  of the article;  “Intestinal Microbiota and the Role of Fecal Microbiota Transplant (FMT) in Treatment of C. difficile Infection,”   

written by Dr. Lawrence L. Brandt, MD

News of Fecal Microbiota Tranplants have been heavily published recently and the information is being found in popular publications worldwide, as this treatment has been proven to resolve the Clostridium difficile infection.     Dr. Brandt’s information in this article is highly recommended and answers questions that the many combating a C. diff. infections have.  

Clostridium Difficile Infection and Fecal Microbiota Transplantation (FMT): Introduction
A perturbed intestinal microbiome has been associated with an increasing number of gastrointestinal and non-gastrointestinal diseases which brings us to C. difficile infection (CDI) and fecal microbiota transplantation (FMT). Fecal microbiota transplant is the term used when stool is taken from a healthy individual and instilled into a sick person to cure a certain disease. As the exact agent or agents that effect cure is currently unknown, the term fecal microbiota transplant (FMT) presently is preferred to fecal bacterial transplantation, or fecal bacteriotherapy; stool transplant is an accurate but unaesthetic term. Work, learn and network with some of today’s top minds in health care management. Learn more about a Health Administration degree program.
Request information now Information from Industry: I’ve already reviewed the very early history of FMT, but FMT also has been used for centuries in veterinary medicine per rectum to treat horses with diarrhea or per os as rumen transfaunation to treat a variety of illness in cattle. Its first clinical use in the English language dates back to a 1958 case series of four patients with pseudomembranous enterocolitis, three of whom were critically ill. C. difficile had not yet been recognized as a cause of pseudomembranous colitis and Micrococcus pyogenes (hemolytic, coagulase-positive Staphylococcus aureus) was cultured from each patient’s stool. Fecal enemas were administered as an adjunct to antibiotic treatment and all four patients had “dramatic” resolution of symptoms within 24–48 h of FMT; the first use of FMT for confirmed recurrent CDI was reported in 1983 by Schwan et al., in a 65-year-old woman who thereafter had “prompt and complete normalization of bowel function”. Up until 1989, retention enemas had been the most common technique for FMT, however, alternative methods of fecal infusion subsequently were developed including nasogastric duodenal tube in 1991, colonoscopy in 2000,and self-administered enemas in 2010. In 2011, a review was reported of 325 cases of FMT performed worldwide, ~75% of which had been administered by colonoscopy or retention enema, and 25% by nasogastric or nasoduodenal tube, or by EGD.Worldwide mean cure rates to date are consistently around 91% and FMT is effective even in patients with the C. difficile NAP1/BI/027 strain. Route does seem to influence results, however, and when FMT is done via upper tract endoscopy, nasogastric, or nasoduodenal tube, resolution rates are in the range of 76–79% Regardless of route, FMT appears to be safe, with no adverse effects or complications directly attributed to the procedure yet published.

Article in its entirety :  http://www.medscape.com/viewarticle/781565_3