“RePOOPulating" the gut an effective treatment for C. difficile

Thursday, January 10, 2013

Gregory Gloor, a professor in the Department of Biochemistry is co-lead author on a new study that showed what they call "rePOOPulating" the gut with a stool substitute made from intestinal bacterial cultures may offer a new treatment option against a virulent strain of Clostridium difficile.

When antibiotic therapies are not working for stubborn recurrent cases of C. difficile, some patients are getting back to normal by having fecal bacteriotherapy or a stool transplant. The donor stool helps the patient's gut to re-establish normal bacterial levels. But there are concerns about patient acceptance and about donor infection transmission.

The researchers showed the stool substitute preparation can be an effective treatment in chronic cases where antibiotics aren't working, without the "ick factor" of transplanting donor stool. Gloor worked with Queen's University infectious disease specialist, Dr. Elaine Petrof, and microbiologist Emma Allen-Vercoe at the University of Guelph on the study. The synthetic stool was developed in Guelph using a process which mimics the gut. the research is published in the new open access journal Microbiome, found here.

C. difficile infection is a bacterial disease of the gastrointestinal tract which accounts for up to a quarter of antibiotic associated diarrhea. Elaine O Petrof and colleagues treated two patients who were infected with a virulent strain and who had not recovered following treatment with standard antibiotics. Within two to three days, both had recovered.

Working with David Carter at the London Regional Genomics Centre at Robarts Research Institute, the bacteria in the synthetic stool and in the treated patients was genetically tested and it matched up. Six months later there was evidence that probiotics from the stool substitute remained.

Although a wider trial is needed, this proof-of-principal study demonstrates that a stool substitute mixture, with a multi-species community of bacteria may be capable of curing antibiotic-resistant C. difficile colitis.