Fecal transplantation improves outcomes in patients with multi-drug resistant organisms

April 30, 2020

Bethesda, MD (April 30, 2020) -- Transferring fecal matter from the digestive systems of healthy donors to extremely ill patients who had previously been infected with drug-resistant bacteria resulted in shorter hospital stays, fewer bloodstream infections and infections that were easier to treat, according to research that was selected for presentation at Digestive Disease Week® (DDW) 2020. DDW® data will be published in the May online supplements to Gastroenterology and GIE: Gastrointestinal Endoscopy.

The study's researchers conducted the transfer, known as fecal microbial transplantation or FMT, in 20 patients infected during extensive medical care with multi-drug resistant organisms, including carbapenemase-producing Enterobacteriaceae (such as Escherichia coli), vancomycin-resistant enterococci or extended-spectrum beta-lactamase Enterobacteriaceae. Patients were followed for six months after the transplantation and their clinical course compared with six months prior to FMT.

While the resistant bacteria were cleared in only 41 percent of the 17 patients who completed the full follow-up, researchers found other benefits to the patients, who had been repeatedly hospitalized and treated for a variety of severe conditions. The sample included hematological cancer patients in need of stem-cell transplants and kidney transplant patients with urinary and bloodstream infections with bacteria that were multi-drug resistant.

"Many of these patients have had recurrent, prolonged courses of heavy-duty antibiotics, end-of-the-line treatments with high toxicity profiles, and repeated hospital stays. They had given up work or had family members forced to give up work to care for them -- having a huge impact on quality of life," said Benjamin Mullish, MD, a lead researcher and clinical lecturer in the Division of Digestive Diseases, Imperial College London, England. "After this experimental treatment, we saw many in this group being able to go back to work, play with their grandkids and have an overall much better quality of life."

Previous research has found that FMT is effective in treating C. difficile, a difficult-to-treat health care-associated infection that often causes severe diarrhea in hospitalized patients. For this study, researchers wanted to know whether FMT could help decolonize, or remove from the patients' bodies, multi-drug resistant bacteria that have developed resistance to more than one type of antibiotic. Multi-drug resistant organisms require broader-acting last-resort treatments that can have severe side-effects. Researchers also wanted to know if FMT could impact other clinical outcomes like length of hospital stay, readmissions and development of bloodstream infections.

Across all patients, there was a reduction in bloodstream infections with resistant organisms and total bloodstream infections. Eight patients improved to a point where they were able to undergo stem-cell transplants within six months after FMT. No serious adverse events related to FMT were reported.

The results suggest that the benefits of FMT may not be only from decolonizing resistant organisms, but there may be positive impacts from other microbiota-related mechanisms that require additional study.

A limitation of the study is that instead of a using a control group, researchers compared patients' conditions before and after treatment, but results were dramatic enough in these very sick patients to warrant additional research.
-end-
The research (abstract 1144) was funded by National Institute for Health Research, via the Imperial College Biomedical Research Centre, and Medical Research Council.

Digestive Disease Week® (DDW) is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. Jointly sponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA) Institute, the American Society for Gastrointestinal Endoscopy (ASGE) and the Society for Surgery of the Alimentary Tract (SSAT), DDW showcases more than 5,000 abstracts and hundreds of lectures on the latest advances in GI research, medicine and technology. More information can be found at http://www.ddw.org.

Digestive Disease Week

Related Bacteria Articles from Brightsurf:

Siblings can also differ from one another in bacteria
A research team from the University of Tübingen and the German Center for Infection Research (DZIF) is investigating how pathogens influence the immune response of their host with genetic variation.

How bacteria fertilize soya
Soya and clover have their very own fertiliser factories in their roots, where bacteria manufacture ammonium, which is crucial for plant growth.

Bacteria might help other bacteria to tolerate antibiotics better
A new paper by the Dynamical Systems Biology lab at UPF shows that the response by bacteria to antibiotics may depend on other species of bacteria they live with, in such a way that some bacteria may make others more tolerant to antibiotics.

Two-faced bacteria
The gut microbiome, which is a collection of numerous beneficial bacteria species, is key to our overall well-being and good health.

Microcensus in bacteria
Bacillus subtilis can determine proportions of different groups within a mixed population.

Right beneath the skin we all have the same bacteria
In the dermis skin layer, the same bacteria are found across age and gender.

Bacteria must be 'stressed out' to divide
Bacterial cell division is controlled by both enzymatic activity and mechanical forces, which work together to control its timing and location, a new study from EPFL finds.

How bees live with bacteria
More than 90 percent of all bee species are not organized in colonies, but fight their way through life alone.

The bacteria building your baby
Australian researchers have laid to rest a longstanding controversy: is the womb sterile?

Hopping bacteria
Scientists have long known that key models of bacterial movement in real-world conditions are flawed.

Read More: Bacteria News and Bacteria Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.