annals of medical history, this could go down as one of the most effective but
stomach-churning treatments ever devised.
seeking a cure for a deadly superbug have successfully treated patients using
Trials in a
Scottish hospital have shown patients suffering from the Clostridium difficile
bug can be cured using 'donor stool' administered via a tube through the nose
into their stomach.
difficile was last week at the heart of a damning report into cleaning failures
at the Maidstone and Tunbridge Wells NHS Trust in Kent, which resulted in the
deaths of 90 patients.
6,000 Scots are affected every year by the severe and potentially fatal form of
infectious diarrhoea. Six patients at the Victoria Infirmary in Glasgow are
currently being treated for the infection in an isolation unit.
difficile is a particular problem among patients who have been prescribed
strong antibiotics as they also wipe out the so-called 'friendly'
disease-fighting bacteria in the intestine. Faecal 'transplants', as they are
known, are believed to restore the bacteria to levels at which they help the
involved in the trials admit there are "obvious aesthetic problems"
in the treatment, which involves patients ingesting a liquidised sample of
faeces from a partner or close relative.
the treatment has the potential to save the lives of hundreds of patients
infected with one of Britain's most serious hospital-acquired infections.
treatment of Clostridium difficile involves the use of antibiotics. But doctors
at Glasgow's Gartnavel Hospital have conducted a trial of 'faecal transplants'
on 12 patients for whom antibiotics had failed to stop repeated bouts of the
the treatment, nine of the patients had no further incidents of the illness.
One was initially cured but was later reinfected. The remaining two patients
had a further bout but then responded well to antibiotics. A source close to
the study said: "The antibiotics basically upset the delicate ecosystem
within the gut and that allows the Clostridium difficile to take over and cause
transplants allow doctors to reintroduce friendly bacteria into the gut, from a
donor, using 30g of faeces. These recolonise the recipient's gut, restoring the
health of the large intestine and killing off the bug.
takes about two weeks, during which donors are screened for suitability and
other treatments are tried out. The key requirement is that donors should not
have recently been on antibiotics themselves.
then mix the donated faeces with water to allow it to travel through a tube.
Despite the positive results, doctors stress that they still regard the faecal
transplant as a "last resort" because it is cumbersome and the idea
of is unpleasant.
Poxton, professor of microbial infection and immunity at the University of
Edinburgh and chair of the European Study Group on Clostridium difficile, said:
"People with recurrent problems will try anything. This is patient driven.
involves a transplant from the spouse or another relative with a healthy gut.
The donor is screened to make sure they do not have Clostridium difficile or
anything that the patient would not want to catch."
"There is something in the faeces that is working and the next step is to
isolate that so that it could be made into a treatment."
MacConnachie, specialist registrar in infectious diseases at Gartnavel
Hospital, presented a report on the new treatment to the Scottish Microbiology
Society's symposium in Glasgow on hospital acquired infections.
decided to try the idea in 2003 with a patient with long-term recurring
Clostridium difficile after a US study flagged up the idea.
is believed to be the first of its kind, and shows that the treatment can work
on the clinical front-line.
investigation concludes: "This technique is time consuming to set up and
suffers from obvious aesthetic problems. However, it does offer a treatment to
patients who have repeatedly failed to settle with conventional therapy."
Clostridium difficile has been causing concern in recent years as it is far
more difficult to kill through conventional hospital cleaning than MRSA. In
Scotland, the number of sufferers who have died has risen in the past five
years from 170 in 2001 to 313 in 2005.
Up to half
of sufferers can experience repeated bouts despite antibiotic treatments.
can survive in the environment for a long time, resisting cleaning by
detergents, and can spread from patient to patient. It is best controlled
through regular handwashing with soap and water.
Government spokeswoman said: "We would encourage boards to share any
information on good practice when tackling infections such as Clostridium