Faecal transplantation has taken on a new name recently decided upon by the North American Working Group in the area. It will now be called faecal microbiota transplant or FMT. This indicates that the origin of the bacteria is from faeces,
Microbiota and in fact that we are Transplanting living cells. The stimulus for growing interest in FMT is the widespread epidemic in the US of Clostridium difficile strain especially 027 which produces 20 – 30 times more toxin and is responsible for killing more than 100,000 patients across North America.
It is a much more severe strain than that seen generally in Australia.
Australia however is bracing itself for the arrival of this strain which in fact has hit our shores with over 25 cases reported in Australia. There have been very few deaths at this stage but it is likely that we will have hospitals infected with the strain and this will spread to patients. Indeed this has already happened in Melbourne. CDD has been readying itself developing expertise in FMT and is the leading institution in the world with over 1550 infusions compared to perhaps the most experienced place in the US having done just under 50. No other institution in Australia has reached the expertise in this area which may end up with time being a life saving treatment for many in Australia. New research has resulted in a trial product which consists of over 99% bacteria having impurities filtered from stool bacteria work. The reason that probiotics do not work in this situation is that we cannot culture all of the stool bacteria and once cultured they do not implant and are damaged by the culture process. Hence the “wild types” of bacteria in the stool are required as they implant and are capable of killing C. difficile and other pathogens which may cause Irritable Bowel Syndrome or Constipation or even Ulcerative Colitis. The serious parts asidebecause we are dealing with stool, terminology has evolved which is unique to the process. Hence patients often refer to the process as a “transpoosion”, or that we are developing a new area of “therapootics”. In the US the newly purified 99% frozen product may well carry the name of a “popsicle”. All that aside the CDD is very proud to have full time staff that carry out FMT in patients with C. difficile, Irritable Bowel Syndrome, constipation and most recently in Ulcerative Colitis. In fact quite a few patients do have C. difficile superinfecting Crohn’s or Ulcerative Colitis which is also treated to remove that aggravating infection. CDD services a number of hospitals which refer patients for the treatment with C. difficile super infection and results can be quite dramatic in those patients who might have in excess of 15 – 20 diarrhoeal stools per day. SR Sharyn Leis has been a full time leader of FMT and has treated countless patients both in Australia and helped via telephone in the US and Europe taking patients through their therapies with their own doctors. Patients frequently fly for treatment from overseas to the CDD which we are proud to foster, we now predict a move of FMT into Ulcerative Colitis and other applications including some Neurological disorders.