Cure for Clostridium

A News Focus article in Science describes a procedure used to treat intestinal bacterial infections by flushing the colon and transferring stool containing healthy bacterial flora from a donor into the patient. The story recounted goes as follows. An 81-year-old woman was seriously ill from an intestinal bacterial infection. She was treated with the antibiotic vancamycin, but antibiotic resistant bacteria developed. Her physician, Max Nieuwdorp at the Academic Medical Center in Amsterdam, didn't give up and searched PubMed. He found a paper from 1958 in the journal Surgery by Ben Eisenman of the University of Colorado, Denver. In that paper, Eisenman described an anal infusion of liquidized stool in patients suffering from an intestinal malady called pseudomembranous enterocolitis; the infusion cured them of the disease. So Nieuwdorp decided to flush the woman's colon out and replaced it with healthy bacterial flora by transferring a saline solution containing her son's feces into her intestine. She got better.

Nieuwdorp and co-workers went on to successfully repeat this fecal transplant procedure in other patients, publishing their results in January of 2013 in the New England Journal of Medicine. Other physicians have independently discovered and applied this procedure to patients, two notable pioneers being Thomas Borody and Lawrence Brandt of the Montefiore Medical Center in New York City. It is now an established mode of treatment and is known as fecal bacteriotherapy (or fecal microbiota transplantation or stool transfer) and has promise for the treatment of other diseases as well. Despite the initial yuck factor, a doctor near you may recommend that you undergo this treatment one day. It's even going DIY.

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Science 30 August 2013: 
Vol. 341 no. 6149 pp. 954-957 
DOI: 10.1126/science.341.6149.954

NEWS FOCUS

MEDICAL RESEARCH

The Promise of Poop

1. Jop de Vrieze*

A controlled clinical trial published in January 2013 has shown that fecal transplants can help cure recurrent infections with Clostridium difficile. Researchers think patients with other diseases, too, may benefit from the procedure, but much more study is needed. Meanwhile, scientists are trying to understand the underlying mechanisms and hoping that, in the future, they will be able to transplant selected bacterial strains instead of human stool.