Pills Simplify Fecal Transplants To Treat C. difficile Infections

Clostridium difficile bacteria hospitalize more than 100,000 people in the U.S. every year with gastrointestinal infections. With the pathogens becoming increasingly resistant to conventional antibiotics, some doctors are turning to fecal microbiotic transplants as a treatment. Moving microbes from healthy donors to patients can restore order in an infected gastrointestinal tract. But getting the good bugs in usually requires an invasive procedure. A team of doctors has now developed a transplant in an easy-to-swallow, encapsulated form to combat persistent or recurrent C. difficile infections (J. Am. Med. Assoc. 2014, DOI: 10.1001/jama.2014.13875). The researchers blended donor stool samples with saline solution to create a slurry, which they then filtered and centrifuged to isolate the microbes. By suspending the beneficial bacteria in a glycerol solution, the team could pipette them into capsules and preserve them in a freezer. In a Phase I clinical trial, 18 of 20 patients who took the capsules were relieved of the diarrhea caused by C. difficile. “This is just a crude first study,” says Ilan Youngster of Boston Children’s Hospital, a member of the research team. “The future is defining what is it—or who it is—in the stool that’s fighting these infections.”