Fecal transplant against relapsing Clostridium difficile-associated diarrhea in 32 patients

Abstract

Clostridium difficile-associated disease (CDAD) with frequent watery stools, sometimes with painful bowel movements, fever and sickness, is probably the major known cause of antibiotic-associated diarrhea and colitis, most probably depending on a disruption of the normal intestinal balance in the microbiome. In this study, we have inoculated a mixture of fecal microbes – as an enema – originating from a healthy Scandinavian middle-aged donor, regularly re-cultivated under strict anaerobic conditions for more than 10 years, to 32 patients. Twenty-two patients (69%) were durably cured. In those patients receiving the transplant by colonoscopy, four out of five were cured. To the best of our knowledge, this is the first time a fecal culture of microbes has retained the possibility for years to cure a substantial number of patients with CDAD.

Key Words::

• anaerobic fecal culture
• CDAD
• Clostridium difficile
• fecal transplant

Acknowledgements

We greatly acknowledge the staff at the gastrointestinal unit at Stockholm South General Hospital for installing the fecal culture by gastro- and/or colonoscopy and Professor A Berstad, Norway, for delivering the initial fecal sample and for his deep knowledge and interest in fecal culture transplantation.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.