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Tuesday, July 12, 2011
Fecal transplants being used to treat stubborn C. difficile cases
TORONTO - With C. difficile outbreaks plaguing several Ontario hospitals, more attention is turning to an ad hoc treatment that has been used for more than 50 years in Europe to treat stubborn cases.
Since the first outbreaks were reported in May, a total of 100 cases and 20 deaths have occurred at eight hospitals in Ontario. Toronto East General, Lennox and Addington Hospital in Napanee and a Hamilton hospital managed to bring the spread of the bacterial disease under control over the weekend, while hospitals in Mississauga, Orangeville, Guelph, Niagara Falls, St. Catherines and Welland continue to battle the virulent bug.
Fecal transplants have been known anecdotally to have had 80 to 100% effectiveness in curing patients infected with grave cases of C. difficile, which do not respond well to normal antibiotic treatment.
Dr. Suzy Hota, an Infection Disease Specialist at the University Health Network, is recruiting patients for the first North American randomized controlled trial on transplanting fecal material to treat people with C. difficile.
“It’s a promising and exciting way to approach the problem,” Hota said.
C. difficile develops an intestinal infection when the colon is overwhelmed with bacteria and organisms like C. difficile, which overgrows and outcompetes the healthy balance. A fecal transplant helps reconstitute the healthy balance of missing organisms and bacteria the colon requires.
The donated stool is used after rigorous screening. The donation is processed in the lab and packaged in an enema bag and infused in a sterile set of lab conditions.
Hota says fecal transplants are being used by some doctors, but it is not a first line of treatment and it’s reserved for people who do not respond well to the usual antibiotic treatment.
Hota said doctors are allowed to perform fecal transplants but it’s not something used widely.
Hota is recruiting 146 patients aged 18 and older who are infected with C. difficile.
For information, log onto http://clinicaltrials.gov/ct2/home.