New pill could stop superbug in its tracks

A pill with healthy fecal material could eliminate C. Diff


HOUSTON, Texas – Clostridium difficile, also known as C. Diff, is a gut bacteria that sickens more than 400,000 Americans each year and kills 14,000. The deadly bacteria is easily transmitted in hospitals and nursing homes. Now human waste in an oral form could be the key to eliminating it.

Last December Lydia Smelton had her teeth removed and was treated with antibiotics. She's been fighting a recurrent bacterial infection C. Diff ever since.

"I didn't have a life anymore," she said.

C. Diff causes intense bouts of infectious diarrhea and it's been nearly too much for Smelton.

"I was really considering how to just end it all," she said. "I mean it wasn't a life. There was no point."

But now there's new hope in an unlikely source. Lydia is about to undergo a fecal microbiota transplant or FMT.

Dr. Herbert DuPont, Chief of Internal Medicine at Baylor St. Luke's Medical Center, will take the good bacteria in a donor's feces and replace the bad bacteria in her gut using a colonoscopy.

"This is a miraculous therapy. There is nothing like this in medicine," DuPont said.

Even more amazing? The active, healthy ingredients will soon be tested in pill form.

"They will work," said DuPont,"We're quite certain."

 "I'm very hopeful," said Smelton.

Just days after her interview, Smelton said she was thrilled with the results and feels like herself again. She's back to doing all the things we take for granted like shopping at the grocery store and sitting through a movie without an accident.

Additional Information:

C. Diff is typically associated with healthcare facilities and hospitals where there are a much higher percentage of individuals who carry the bacteria. However, recent studies are showing an increased risk in community-associated C. Diff diagnosis in children and people who have not been recently hospitalized or administered antibiotics. Although the intestine contains millions of bacteria, mostly healthy, taking antibiotics can destroy the bad bacteria along with the good. This can cause C. Diff to grow rapidly. Fluoroquinolones, cephalosporins, clindamycin and penicillins are the most common antibiotics that lead to C. Diff infections.
(Source: http://www.mayoclinic.org/diseases-conditions/c-difficile/basics/causes/con-20029664)


TREATMENT: According to the Center for Disease Control and Prevention, halting all antibiotics is the first step. However, there are certain antibiotics that can help with the symptoms of C-diff. Metronidazole, while not approved by the FDA for C-diff treatment directly, has been recommended for treatment of mild/moderate C-diff infections. If metronidazole does not work within 10 days of beginning treatment, future infections can be managed by oral vancomycin or fidaxomicin. (Source: http://www.cdc.gov/hai/organisms/cdiff/Cdiff-patient.html)

NEW PROCEDURE: Fecal Microbiota Transplant (FMT) is the process of mixing healthy donor fecal matter with saline and then inserting into a patient via colonoscopy, endoscopy, sigmoidoscopy, or enema methods. In 2013, this procedure was simplified dramatically by turning the transplantation into a pill in a study led by Thomas Louis, MD, of the University of Calgary in Alberta, Canada. The pills are created by processing the healthy feces until it contained only the concentrated bacteria. It is then encapsulated by three layers of gelatin capsule to ensure the pills won't disintegrate or leak until it was well into the small intestine. This method is less invasive for patients as well as less costly than an actual FMT. The capsule/pill is created for each individual patient, usually with a fecal donation by a relative, on the day it is to be administered. Donors and recipients are tested for parasites, invasive diseases and blood-borne infections prior to transplants. Stool banks and other sources for pooled fecal samples are not used in this type of pill-based treatment.
(Source: http://thefecaltransplantfoundation.org/what-is-fecal-transplant/, http://www.sciencedaily.com/releases/2013/10/131004105253.htm, http://www.medpagetoday.com/MeetingCoverage/IDWeek/42044