PSA: C. Difficile Infections and Fecal Transplants

[JumpyTheFrog]

http://www.openbiome.org/about-fmt/

 

Open Biome offers pre-screened samples for fecal transplants. It was started after a friend of the founds suffered from a c. diff infection for 18 months until he or she was able to get a fecal transplant and finally recover.

 

http://www.scientificamerican.com/article/hospitals-fail-to-take-simple-measures-to-twart-deadly-infections/

 

According to the above article, hand sanitizers don't effectively stop the spread of c diff. Washing with soap and water does a much better job removing the bacterial spores.

 

Washing of bedrails, doorknobs, and other surfaces in hosptials with bleach is essential to curbing the spread. Another article said a study found only 39% of surfaces in hospitals that should be cleaned are cleaned by the janitors. This is outrageous! If you are visiting someone in the hospital it's probably a good idea to buy some bleach wipes and wipe everything down yourself every day.

 

Some hospitals are testing UV lights that could be used to sanitize rooms. I hope that works well because the current practice of allowing the janitors to decide by looking if the room is clean enough isn't working.

[prairiewindmomma]

We do pack bleach wipes for hospital stays. We have had family members die from c.diff. :(

[JumpyTheFrog]

One article I read said that the spores were found on about a third of all hospital blood pressure cuffs! Gross! At home, I am jot a germophobe and follow the five second rule, but if any of us had to go to the hospital, I'd be the crazy lady demanding everyone wash their hands and wipe down all their tools.

[sbgrace]

My son has carried C-Diff since he was hospitalized at 3.5. We control symptoms with heavy duty probiotics. He is always positive on stool tests, and sometimes it takes over and causes breakthrough symptoms. I honestly wonder if it was possibly the trigger for his OCD.

 

I regret that I didn't know more when he was in the hospital. I remember all the doctors/nurses taking a squirt of hand sanitizer (the hospital anti-bacterial sort, which still doesn't control c. diff) as they walked in. I had no clue.

[wapiti]

Interesting, OP!  The microbiome of the gut is a fascinating frontier.

[fairfarmhand]

We also have a family member who died from c. diff.

 

Horrible.

[JumpyTheFrog]

My son has carried C-Diff since he was hospitalized at 3.5. We control symptoms with heavy duty probiotics. He is always positive on stool tests, and sometimes it takes over and causes breakthrough symptoms.

Maybe you should look into a fecal transplant for him. It would probably help him and prevent the rest of you from getting it. They have a 90+% effectiveness rating in studies, and that's on patients that have run out of antibiotics to try. I assume they'd be even more effective with patients with less serious cases.

 

Some people try to do their own fecal transplants. One problem with this is (aside from the expense of screening the donor) is that most of the beneficial bacteria are anaerobic, so the "blender approach" kills them. Still, I think I have read anecdotal stories of people who did it at home (not for c diff) and received benefit.

 

Another idea would be to do probiotic enemas.

[wapiti]

As I understand it, fecal transplants are approved for c-diff only and are specifically prohibited from being done by a medical practitioner for other diagnoses (which is odd, but that's another story).  I was looking into it for other reasons - it's really quite interesting.

[JumpyTheFrog]

Yeah, it's amazing how a fecal transplant is only allowed for someone who would probably otherwise die of c diff, but making them take endless amounts of antibiotics is just dandy. Especially when antibiotics kill off the gut flora that help protect us from infections. ::Eyeroll::

 

Yes, I know this needs to be studied, but it is seriously annoying that so many people will suffer or even die in the next decade or two while they wait for enough studies to show that it is viable option. Not to mention how many other people could be treated for other various conditions related to destroyed gut flora (see my other thread on low diversity and type 1 diabetes).

 

There is a clinic in the UK that does FMTs for international patients willing to fork over the big bucks.

[JoJosMom]

Yeah, it's amazing how a fecal transplant is only allowed for someone who would probably otherwise die of c diff, but making them take endless amounts of antibiotics is just dandy. Especially when antibiotics kill off the gut flora that help protect us from infections. ::Eyeroll::

 

Yes, I know this needs to be studied, but it is seriously annoying that so many people will suffer or even die in the next decade or two while they wait for enough studies to show that it is viable option. Not to mention how many other people could be treated for other various conditions related to destroyed gut flora (see my other thread on low diversity and type 1 diabetes).

 

There is a clinic in the UK that does FMTs for international patients willing to fork over the big bucks.

 

If you are interested, there was a recent article published about the connection between gut bacteria and obesity. Specifically, a few individuals who have received fecal transplants from obese (but otherwise healthy) donors appear to "inherit" obesity; the scientists are now interested in exploring the link between gut bacteria and obesity. Contained within the article, I believe, were the names of some clinics that will do the transplant. I'm sorry, but I cannot remember where I read the information (I peruse the Interwebs rather broadly and eclectically), but you should be able to Google it, in case you know of anyone seeking this particular treatment.

 

 

[sbgrace]

If you are interested, there was a recent article published about the connection between gut bacteria and obesity. Specifically, a few individuals who have received fecal transplants from obese (but otherwise healthy) donors appear to "inherit" obesity; the scientists are now interested in exploring the link between gut bacteria and obesity. Contained within the article, I believe, were the names of some clinics that will do the transplant. I'm sorry, but I cannot remember where I read the information (I peruse the Interwebs rather broadly and eclectically), but you should be able to Google it, in case you know of anyone seeking this particular treatment.

 

That's absolutely fascinating. 

[JumpyTheFrog]

They've done similar studies with mice. Fecal transplants from lean mice to obese result in fat loss. Transplants from obese to lean result in weight gain, even on the same diet.

[JumpyTheFrog]

Recently I thought one of my kids was going to need an antibiotic. I was trying to figure out how to store some, er, samples from him to give him a "transplant" a few weeks later. Fortunately, he didn't need anything after all.

[JumpyTheFrog]

The more I learn about gut flora, the more amazing it is. I heard a TED talk about some bacteria that are bioluminescent. The thing it took a long time to figure out is why they wouldn't glow until the bacterial count in a colony reached a certain population. It turns out that bacteria chemcially communicate with each other using a process called quorum sensing. (I believe some beneficial ones communicate by making vitamins for us in the colon.) The quorum sensing was in effect a census and none of them glowed until a certain number where there and then they'd suddenly all start glowing.

 

Some people believe that quorum sensing is what allows pathogenic bacteria to take over and cause a gut infection. Nobody ever has all beneficial bacteria. It seems that the pathogens are kept in check until the diversity goes down (not enough fiber in the diet or taking antibiotics.) When the pathogens increase in number enough, they may use quorum sensing to "decide" that it's time to work together to mount an attack.

[Jasperstone]

Recently I thought one of my kids was going to need an antibiotic. I was trying to figure out how to store some, er, samples from him to give him a "transplant" a few weeks later. Fortunately, he didn't need anything after all.

Can I ask 'why' and 'how' you would have transferred it? Enema?

 

I know that it sometimes the only option, but I have trouble getting my head around it. To me, it sounds like such an extreme thing to do.

[JumpyTheFrog]

To be honest, this particular child never would've allowed me to give him an enema to implant it, so it wouldn't have happened.

[Jasperstone]

To be honest, this particular child never would've allowed me to give him an enema to implant it, so it wouldn't have happened.

So, is this something some people are doing (sorry, never heard of that before)- keep BM before you start a course of antibotics? Then, transfer it back when finished with the course?

[JoJosMom]

So, is this something some people are doing (sorry, never heard of that before)- keep BM before you start a course of antibotics? Then, transfer it back when finished with the course?

 

No, I don't think so.  And it would be a bad idea to experiment with, IMO.  It does show promise as treatment for certain conditions which is great. BUT I think one would be better off finding a medical practioner who does the procedure, or at least carefully research the "how" and "when" it's justified. From the little I've read, it would be an extreme response to a normal round of antibiotics. Now, if a person were treated for an antibiotic-resistant infection of some sort and had received multiple rounds of the nasty stuff required to treat them, then this treatment could be a good fit. The OP may be a better person to answer, though. 

[JumpyTheFrog]

So, is this something some people are doing (sorry, never heard of that before)- keep BM before you start a course of antibotics? Then, transfer it back when finished with the course?

 

No, but I think in the next few decades, it may become something that doctors start to recommend.

 

http://www.ncbi.nlm.nih.gov/pubmed/19018661

 

The above study found that after treatment with cipro, while many groups of bacteria recovered within four weeks, several were still missing after six months. If someone takes antibiotics multiple times, think how much that may decimate the flora. I was on a ton of antibiotics as a kid, and even though I've only taken maybe one course in the last fifteen years, my gut flora diversity is still very low.

[JumpyTheFrog]

It does show promise as treatment for certain conditions which is great. BUT I think one would be better off finding a medical practioner who does the procedure, or at least carefully research the "how" and "when" it's justified. 

 

But see, the problem is that it will take 20 years for the FDA to approve it for much. Meanwhile, we have an autoimmune epidemic and people suffering. I don't know if the big studies needed to get approval will be funded because selling screened poop isn't very profitable compared to patented drugs. I am not recommending anyone do their own fecal transplants, just that when faced with the possibility of my son getting them, I wanted some way to protect his gut flora. He was nursed for 2 1/2 years and has never been on antibiotics, so that may already put his gut flora way ahead of most of the population - certainly much better than mine.

 

The research seems to be showing that while probiotics are good, they don't tend to colonize the gut well. They tend to just pass through, although that is still beneficial. Fecal transplants may be the only reliable way to truly restore the flora.

[clementine]

We have a friend that had a fecal transplant for c.diff. - it was the thing that finally worked for her.  

 

At the time, I couldn't think of anything more disgusting, but I'm happy that there was research that discovered this treatment.  

[JoJosMom]

But see, the problem is that it will take 20 years for the FDA to approve it for much. Meanwhile, we have an autoimmune epidemic and people suffering. I don't know if the big studies needed to get approval will be funded because selling screened poop isn't very profitable compared to patented drugs. I am not recommending anyone do their own fecal transplants, just that when faced with the possibility of my son getting them, I wanted some way to protect his gut flora. He was nursed for 2 1/2 years and has never been on antibiotics, so that may already put his gut flora way ahead of most of the population - certainly much better than mine.

 

The research seems to be showing that while probiotics are good, they don't tend to colonize the gut well. They tend to just pass through, although that is still beneficial. Fecal transplants may be the only reliable way to truly restore the flora.

 

I actually agree with you. I simply meant that I did not think it would be a good idea for an individual to try to do the procedure herself, absent a whole lot more research, etc. The practioners to whom I was referring would be the ones currently doing the procedure.  The article that I read mentioned a few; I wish I could remember where I read it.

 

I apologize for being unclear. As a person who benefited from an experimental (and now FDA-banned) procedure to deal with autoimmune issues and miscarriage I TOTALLY understand what you are saying.

[TranquilMind]

http://www.openbiome.org/about-fmt/

 

Open Biome offers pre-screened samples for fecal transplants. It was started after a friend of the founds suffered from a c. diff infection for 18 months until he or she was able to get a fecal transplant and finally recover.

 

http://www.scientificamerican.com/article/hospitals-fail-to-take-simple-measures-to-twart-deadly-infections/

 

According to the above article, hand sanitizers don't effectively stop the spread of c diff. Washing with soap and water does a much better job removing the bacterial spores.

 

Washing of bedrails, doorknobs, and other surfaces in hosptials with bleach is essential to curbing the spread. Another article said a study found only 39% of surfaces in hospitals that should be cleaned are cleaned by the janitors. This is outrageous! If you are visiting someone in the hospital it's probably a good idea to buy some bleach wipes and wipe everything down yourself every day.

 

Some hospitals are testing UV lights that could be used to sanitize rooms. I hope that works well because the current practice of allowing the janitors to decide by looking if the room is clean enough isn't working.

Ahhh...this is scary to read now.  A decade ago, I took care of my Mom in my home - with my young children.  Fortunately, I am a freak about germ transmission. 

 

I know they do a sucky job in the hospital.

[Jasperstone]

But see, the problem is that it will take 20 years for the FDA to approve it for much. Meanwhile, we have an autoimmune epidemic and people suffering. I don't know if the big studies needed to get approval will be funded because selling screened poop isn't very profitable compared to patented drugs. I am not recommending anyone do their own fecal transplants, just that when faced with the possibility of my son getting them, I wanted some way to protect his gut flora. He was nursed for 2 1/2 years and has never been on antibiotics, so that may already put his gut flora way ahead of most of the population - certainly much better than mine.

 

The research seems to be showing that while probiotics are good, they don't tend to colonize the gut well. They tend to just pass through, although that is still beneficial. Fecal transplants may be the only reliable way to truly restore the flora.

My ds was also BF for over 2 yrs. Unfortunately, he had an accident that took off the tip of his finger. He went on a course, and has had ezcema and other symptoms since. He is nearly ten now.

 

There is a brand I get from the States that has different strains. The first one is bifittus (sic)- that lines and prepares the gut, and then they have one with the good bacteria. Apparently, it's the only one that does that.

 

Anyway, I'm using it with my ds now. Only on the first stage, so can't comment where it works or not yet.

[Pippen]

There's a newer antibiotic called Dificid that's specific to c. diff and more effective than Vancomycin. It worked for a family member with a stubborn infection. It's expensive, so insurance companies don't like to cover it.

[Spryte]

There's a newer antibiotic called Dificid that's specific to c. diff and more effective than Vancomycin. It worked for a family member with a stubborn infection. It's expensive, so insurance companies don't like to cover it.

 

Thank you.  I'm so happy to know about this.  I've had recurring C Diff (nightmare that lasted years) and it was only solved by months and months on vanco.  My last round ended with a relatively rare reaction to vanco - red man syndrome.  I've lived in fear of another C Diff recurrence.  Next step is fecal transplant - it would have to be.

 

This gives me hope.  :)

[Pippen]

Spryte, glad to pass on the info. It was horrible dealing with it for a few months so I can just imagine how miserable it has been for the long term. He was being treated at a major university hospital and we got to know the infectious disease doctor well. She wouldn't have hesitated to recommend fecal transplant if the Dificid didn't work. They've had very good results.

[Tiramisu]

Interesting, OP!  The microbiome of the gut is a fascinating frontier.

 

 

FWIW, oddly enough, the supplement s. boulardii (which is thought to combat c-diff effectively, as you probably know) is somehow involved in the timing of my ds's sudden-onset OCD.  (We recently added a couple of possible infectious triggers to our list, lyme and bartonella, with the bart being the likely culprit for the OCD.  We shall see, we shall see...)

 

Interesting. Though many GI specialists recommend s. boulardii (Florastor), one of my GI's is opposed to its use. I think due to the fact that it can cause infections elsewhere in the body especially if your gut lining is compromised as it can be in CDiff. 

[Tiramisu]

Another interesting factoid about CDiff is that up to 1/3 of people have it in their systems, determined by random stool sampling. I read this years ago and I can't supply a source. If this is true, any of us can have CDiff bacteria in our gut that's waiting for an opportunity to take over. The reason why it can spread in hospitals so easily is that many hospitalized patients are on antibiotics, and probably strong, wide-spectrum ones. 

 

A medical assistant at my GI's office said that most CDiff patients they see are people who were treated with antibiotics for dental infections, as I was. I would assume those people never remember becoming in contact with anyone with CDiff. In my case, my entire family could have been exposed by CDiff infection as I was sick for weeks before I was diagnosed and started washing everything with a bleach solution. So far, four years later, no one has come down with it even though they have taken antibiotics. But it's upsetting to think that they could eventually become very sick because of me.

 

One GI doctor told me that it could take up to four months after antibiotic use to come down with CDiff. I have had to be on antibiotics once since having CDiff and it was a scary four month wait until I felt in the clear.

 

Another interested fact I remember reading, women who get CDiff in the spring are more likely to relapse. My theory as to why this happens is related to the fact that pollen causes intestinal inflammation. I suspect that weakens the gut lining and disrupts the normal biome to some degree. I just don't know why women would be more susceptible to relapsing except for hormonal changes that affect the bowel. Incidentally, I have a history of IBS symptoms in the spring that preceded CDiff.

 

When I got sick, I had been on two rounds of antibiotics and then got a stomach virus that went through the house. Everyone got better but I got worse. I still wonder if it hadn't been for the stomach virus, if my bowels wouldn't have been pushed to the point of allowing the CDiff to take over. And FWIW, I was taking probiotics at the time. Perhaps just not the right ones.

[JumpyTheFrog]

I read a few days ago that 5% of people harbor C. Diff. From what I've read, it spreads *very* easily at hospitals. My opinion is that besides the poor sanitation at hospitals, so many people are on antibiotics that wipe out the good gut flora that are keeping the pathogens in check.

 

Think of it like this. Most people have at least a few dandelions growing in their yard, no matter what they do. Imagine if someone dumped herbicide all over the lawn and killed off patches of grass through the yard. While the grass may eventually recover, the dandelions will likely take over those spots first because the grass couldn't keep their population in check anymore. Furthermore, imagine if the dandelions chemical communicated through quorum sensing, like bacteria, and when they reached a certain population became more virulent, say by doubling seed production. Then the yard would be even harder to reclaim.

 

Now if a person did nothing, they should expect weeds to take over and the grass to very, very slowly grow back. Using probiotics would be like seeding the grass and then having birds come eat most of it or the seeds getting washed away by the rain. Fermented foods might be slightly better. A fecal transplant would be like laying down sod over the bare patches.

 

Meanwhile, every round of antobiotics is another round of herbicide dumped on the lawn. Fermentable fibers, resistant starch, and other prebiotics are the fertilizer that helps the grass grow better, but the grass must be there already.

 

I hope this illustration helps someone who is new to reading about gut flora issues.

[JumpyTheFrog]

I still wonder if it hadn't been for the stomach virus, if my bowels wouldn't have been pushed to the point of allowing the CDiff to take over.

Is is entirely possible. Dr. Siebecker (http://www.siboinfo.com) says that people often get IBS after a stomach bug. The stomach bug can slow gut motility, reducing the sweeping motions through the intestines that are meant to push pathogenic bacteria out before they can adhere to the gut lining and start building a biofilm to protect themselves. If the motility is slowed enough, the pathogens gain a foothold in the small intestine, which is supposed to have extremely low levels of bacteria compared to the colon. An overgrowth of any type (including beneficial gut flora) in the small intestine is called SIBO (small intestinal bacteria overgrowth - although funguses can overgrowth there to). Dr. Siebecker says that post-viral IBS is really just SIBO that needs to be treated.

[plansrme]

Ds had c diff when he was three. It scares me because the chance of recurrence is so high. Now he has type one diabetes so it'd be even scarier. But the talk earlier in the thread has me wondering.... Ds has some ocd and dx'd anxiety disorder. Hmmmm.... Something else to look into. Thanks for posting these articles; Im not very familiar with the transplant type treatment.

 

Have you read about FTs being used for diabetes?  When I saw this thread, I remembered a story I read years ago about a doctor in Australia using a FT for MS, I thought, so I googled it to see if that's what I remembered.  In running through google results, I saw several references to using it for diabetes as well.  I barely even know what C diff is, or most of these other conditions for that matter, but I am fascinated by the topic.