On Clostridium difficile and fecal transplants

Josh Clark

Remember the MRSA scare of a couple years ago? Remember, it was before the swine flu scare but after the SARS and avian flu scares. For those who can't recollect, MRSA is a potentially fatal, antibiotic-resistant staph infection, essentially a superbacterium that a lot of researchers believe is the result of the overuse of things like antibacterial soap and the misuse of antibiotic medications. One of the things that made it so frightening was that otherwise healthy people were catching it in hospitals.

MRSA's still around, though the panic has largely died down. Its meteoric rise to prominence in the world media is somewhat baffling when compared to another, generally overlooked hospital-acquired bug that's been going around, Clostridium difficile. I say baffling because C. difficile infections are discovered to be about 25-percent more common than MRSA in a 28-hospital study. At any given time, about half a million Americans are infected with the bacteria, almost all of those cases being acquired either while in the hospital or nursing home, or within four weeks after discharge. While in most healthy people MRSA can be eventually murdered with a huge blast of antibiotics, there's a problem with treating C. difficile in the same manner: It lives in the gut, which also houses colonies of beneficial bacteria that are all annihilated by antibiotic treatments. C. difficile can hang on during these rounds and when they're over, the bacteria has no opponents in the gut and is free to wreak real havoc. In fact, antibiotics leave an individual more susceptible: About 90 percent of C. difficile cases are contracted after a round of antibiotics.

To solve this conundrum, in the 1980s an Australian physician Thomas Borody turned to the field of veterinary science and agrarian folk medicine. He came up with the fecal transplant.

Yes, that's right the fecal transplant. On his hands, Borody had a woman with a case of bacterial colitis which he could not cure. As is described on TheScientist.com, Borody turned to the woman's brother to serve as donor. He complied, as he pretty much had no choice, since everyone knew he was going to produce the stool anyway. Borody added it to a brine, mixed it all together in a blender and created a slurry he injected using an enema into his patient. The doctor went from zero to hero when the woman was cured, without remission, in two or so days.

What Borody came up with was based in principle on old tradition used among livestock farmers and it has become a dirty secret of Western medicine. When the antibiotics won't cure a bug -- for example, Clostridium difficile -- harvesting fecal material from a healthy donor and inserting it reverse-wise into an ailing patient can cure disease.

As disconcerting the concept may be, the seemingly miraculous healing inserting someone else's feces into another person can provide certainly beats dying from a gut infection. It surely must.

(Thanks for the idea, LOML ))<>(( forever.)