Repoopulation Remedy

Transplanting synthetic stool made of beneficial microbes cures deadly diarrheal infections in two patients.

Beth Marie Mole
Jan 9, 2013

WIKIMEDIA, GRAY'S ANATOMYPhony poo containing 33 isolates of commensal microbes cured two patients suffering from recurrent intestinal infections of Clostridium difficile after doctors infused the fake fecal matter into their colons during a colonoscopy. The successful insertion of synthetic stool, published today in Microbiome, provides hope for a much-needed treatment against diarrhea-causing, often drug-resistant infections by C. difficile, for which conventional fecal transplant therapies have failed to develop.

“Fecal bacteriotherapy, or ‘stool transplant,’ . . . has shown promising results in preliminary studies, but concerns about pathogen transmission, patient acceptance, and inability to standardize the treatment regimen remain,” the authors wrote in the study. “This proof-of-principle study demonstrates that a stool substitute mixture comprising a multi-species community of bacteria is capable of curing antibiotic-resistant C. difficile colitis.”

The two patients involved in the study suffered from a hyper-virulent strain of C. difficile known as ribotype 078, which was unscathed by courses of the antibiotic metronidazole and the “last resort” antibiotic, vancomycin. But 2 to 3 days after the synthetic stool transplant, both patients rid their symptoms and remained symptom-free for at least 6 months. Moreover, DNA sequencing of the patients’ stool samples taken during their 6 month evaluations revealed that 25 percent of the overall sequences came from the 33 isolates in the synthetic stool treatment, which were barely present in both patients’ stool prior to treatment. The finding suggests that the treatment not only resolves infections, but may have significant and long-lasting effects on the intestinal flora.