Finally a solution to eradicate C. diff is found

Ashley Chenoweth (11 AM Micro) found this article detailing the promise of fecal transplants to treat chronic intestinal disease. Long time readers of BIO230 will recall my take on this topic, with an extremely difficult BONUS opportunity.

Clostridium difficile, also known as C. diff is a rod shaped, gram positive, endospore producing bacteria known to cause many illnesses in the UK and North America. In 2011, it was the cause of 2,000 deaths in the UK! What is C. diff? C. diff is as opportunistic pathogen with a very high contagious period that lives in the stomach of 3% of adults and 66% of children. Most people that are infected with C. diff get infected by the consumption of antibiotics, which we all know disrupts our normal microbiota. When our normal microbiota is gone, C. diff begins to grow quickly and cause disease.

Symptoms include diarrhea, bloating, abdominal pain and potentially inflame the colon, causing death. The fact that C. diff can create their own endospores makes them very difficult to kill. Luckily, scientists have found a cocktail of six different bacteria that eradicates C. diff in mice!

Scientists took mice that were infected with the C. diff bacteria and tried to treat them with a wide range of antibiotics with no luck. Every mouse relapsed to a higher form of contagiousness or as scientists call it, “shedding.” They then had the idea to treat the mice using fecal transplant. In this procedure, scientists take stool from a healthy mouse and put it in the stomach of the infected one. Gross right? However, it works! The stool that is put into the stomach of the infected mouse helps the regrowth of the normal microbiota in the stomach that was once lost. Once the normal bacteria begin to grow again, the C. diff is no longer able to grow and multiply, therefore getting rid of the bacterial infection.

Fecal transplant has been around since the 1990’s. It has just recently been noticed for the cure C. diff. There are many stories how the arguably unorthodox treatment has helped thousands of clients. Ranging from infants to the elderly, all the patients have been helped and most patients have not had a relapse. This was a revolutionary discovery. However, the scientists wanted to take this experiment one step further.

The scientists tried to isolate the specific bacteria that stopped C. diff and restored normal microbiota growth in the stomach. They cultured many of the normal microbiota that grew in the stomach of mice. They re-cultured many different mixtures of microbiota until they found a cocktail of six that worked best against the C. diff bacteria. This cocktail of six bacteria that was found in the stomach of mice was able to suppress the supershedder (highly contagious) state of C. diff in mice. They then took the genomes of the bacteria in the cocktail and compared them to a family tree to more precisely define them. In doing this, they found that out of the six bacteria, there were three genomes that suppress the growth of  C. diff and interestingly, the mix is “diverse” and found in all four of main groups of bacteria found in mammals.

So how is this news to the health care department? How does this affect us who are going into health care? This knowledge could help stop the over-use of antibiotics in the health care system. The use of antibiotics, although most of the time does not cause many noticeable side effects, causes our normal microbiota to stop working. This can allow opportunistic pathogens to cause disease in our body and sometimes make us more sick than we were in the first place! By isolating what causes the suppression of C. diff, we can give our patients a substance that will help them, with a very small percent chance of a relapse and without having to have someone else’s poop being shoved into their stomach.  As the new generation of health care professionals, we should encourage the continuation of this research and hope that we can use these genomes to help cure other serious diseases such as cholera in the future!

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About ycpmicro

My name is David Singleton, and I am an Associate Professor of Microbiology at York College of Pennsylvania. My main course is BIO230, a course taken by allied-health students at YCP. Views on this site are my own.

Posted on November 5, 2012, in gross, Guest Post, You are what you eat. Bookmark the permalink. 2 Comments.

  1. Christa Gurriera

    I think that the treatment for C.diff is very interesting. The fecal transplant seems very strange to me and I think that an antibiotic would be a much more popular choice for patients diagnosed with this. But it’s shocking that the antibiotics cause a lot of harm to the normal microbiota in the stomach. The isolation technique seems very practical and the research encouraging this goal should be continued.

    • It really isn’t all that far fetched; the business of probiotics has huge potential for restoring the balance of organisms in the lower digestive tract. See for instance this bonus posting from a student last Fall for her take on whether probiotics are useful. (Note; that bonus in that link is now expired!) The upshot of the story was that the normal microbiota actually have subtle physiological effects on the body, which you might not have expected.

      Then there is this link I wrote about last Spring where genetically modified probiotic bacteria might be ingested, and be able to detect small biochemical changes in the body, and respond to those biochemical changes by changing color. Disease diagnosis could then be as simple as taking one of these pills, and then looking to see what color the poop is.

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