NPR and the Boston Globe had articles on a new treatment to fight infections.  When a patient suffers from a gastrointestinal infection that keeps coming back, try transplanting someone else’s feces into the gut to restore a normal balance of healthy bacteria.  Most patients with serious, recurrent infections caused by the bacteria C. difficile got better when donor feces were infused into their intestines.  This infection typically arises after a patient has taken a course of antibiotics — the drugs clean out the normal balance of bacteria in the patient’s gut, allowing opportunistic C. difficile to proliferate. Patients in the hospital for other health problems are particularly vulnerable, and in recent years, a more virulent strain of the bacteria that defies most antibiotics has emerged. The number of deaths climbed from 3,000 during 1999-2000 to 14,000 between 2006-2007, according to the federal Centers for Disease Control and Prevention.

"Interest in the technique has been driven by three powerful forces: the anecdotal experiences of doctors who have found it works, the marked increase in life-threatening C. difficile infections, and the evolving scientific understanding of the role bacteria that live in and on the human body play in maintaining good health."

Artificial poop is a synthetic stool with a mixture containing 33 different types of bacteria created in something called the "Robogut" — a mechanical device that mimics the conditions in your colon.
The synthetic stool — which is called RePOOPulate — to treat people sick with infections from Clostridium difficile, a bacterium that can cause serious, persistent bouts of diarrhea.  The germ can take hold after people are treated with antibiotics for other infections.

"Courtesy of The researchers report in the current issue of Microbiome that the treatment with synthetic poop successfully cured two people of their infections.
Normal bacteria in your gut help protect against toxic pathogens, says Dr. Elaine Petrof, an infectious disease specialist at Kingston General Hospital, who led the study. "When you’re sick and take antibiotics, you knock out the innocent bystanders, too." That messes up the ecosystem in your gut.  Most people can repopulate the good bacteria naturally, but in some cases, C. difficile, which is resistant to many antibiotics, takes over. The bacteria make a nasty toxin that can make people get really sick.  Taking more antibiotics usually wipes out C. difficile. But in some cases, Petrof says, the pathogen just keeps coming back. "It becomes a vicious cycle because the antibiotics keep killing the good bacteria."

That’s where the RePOOPulate could be helpful. The idea is to load up the patient’s GI tract with a bunch of the good bacteria so they push C. difficile out of the way.

Gastroenterologist Darrell Pardi, who wasn’t involved in the study, says the treatments is just one of several recent examples of doctors trying to develop a cleaner version of a fecal transplant. In that procedure, doctors take a stool sample from a healthy person and transplant it into the GI tract of a patient with C. difficile.


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