Clostridioides difficile infection (rCDI) is caused by C. difficile bacterium which is a naturally occurring, spore-forming and anaerobic type of strain. It attaches its spores to the fecal matter which are then transmitted to the oral cavity via hands. Fecal microbiota transplantation (FMT) is one of the most effective treatment plans for this disease as it replaces the injured part of the microflora and replaces it with a healthy microflora obtained from a donor’s stool sample.
Fecal Microbiota Transplantation (FMT) is a unique procedure that takes fecal samples from a healthy donor and transplants them into the gut of a patient through colonoscopy, oral capsules, or naso-enteric tube. In ideal situations, it is a safe procedure but it can also go wrong on some patients.
But after two patients lost their lives in 2019, the concerns on the safety of FMT began to rise urging a safer alternative to this treatment. A research team from Osaka City University in collaboration with the Institute for Medical Science, (University of Tokyo) tried to understand this link, and their results are published in the journal gastroenterology.
Based on the findings of their original study, they used the information from nine patients suffering from Clostridioides difficile infection and were admitted to and Women’s Hospital in Boston. All these patients received FMT and were completely recovered from the condition. But the focus of this study was on how the intestine works with the microflora inside stool sample predicting the safety levels of this treatment plan.
According to the research team, the intestinal microbiota can be considered and treated like any other organ. Using Fecal Microbiota Transplantation (FMT) on a rCDI patient improves the intestinal bacteria as well as virome, together which can restore the natural microbiota of a person.
The reason why Fecal Microbiota Transplantation (FMT) is recommended for Clostridioides difficile infection (rCDI) patients is that antibiotic treatment against this condition kills the protective bacteria inside the gut, causing more harm than benefit. Plus, the spores of C. difficile are highly resistant to antibiotics. It takes only a little time for this bacteria to settle inside the gut and release toxins which can cause distress, diarrhea, and fever in a person. Using the stool sample from a healthy individual can increase the protective bacteria in the patient’s body, completely knocking them out.
Right now, researchers are focused to find the efficacy of FMT against other gastrointestinal diseases, for example, Irritable bowel syndrome and Crohn’s Disease but there is nothing conclusive right now.
FMT has definite benefits for Clostridioides difficile infection (rCDI) patients but it also has its own risks. The stool is not just an accumulation of protective bacteria, there are many other microorganisms resisting, many of which are pathogenic.
It is necessary to screen all the stool donors for possible medical conditions plus the sample itself carries a risk of being contaminated with other pathogens. Additionally, there are procedural risks attached to giving a patient FMT through colonoscopy or any other method of delivering it. More studies are necessary to deliver FMT on these rCDI patients without exposing them to further risks.