Britain approves ‘faecal culture’ to treat antibiotic-resistant germs

The so-called “fecal transplants” have reached an important milestone with the publication of a The new UK guide Which is aware of its effectiveness in the treatment of some chronic intestinal infections.

The National Institute for Health and Care Excellence (NICE) published its recommendation this week saying that the treatment, called fecal microbiota transplantation, or FMT, should be used to treat recurrent infections of Clostridium difficile (C diff).

Nice found FMT to be an effective, safe, and cost-effective treatment for adults who have had two or more C diff infections who have not responded to antibiotics.

C diff is a bacterium that causes debilitating diarrhea. This is usually treated with broad-spectrum antibiotics (i.e. antibiotics that kill many different types of bacteria). Unfortunately, antibiotics can become less effective with each attack.

Fecal transplants are really what it sounds like. A stool culture is prepared from a healthy stool donor that has been carefully screened and processed in a sterile laboratory. They are frozen in the refrigerator -80°C and can be stored for up to six months. Then it is implanted in the patient’s intestines through a tube directly into the stomach or through an endoscope into the stomach or colon, according to what is most appropriate for the patient.

With the transplant restoring normal function in the gut microbiota, the immune system can properly target C teams as “bad bacteria” and restore the gut to normal motility.

These therapies enable the cultivation of the bacteria necessary not only to keep our gut healthy but have been suggested to have a significant impact on a range of disorders, from cancer And the Psychological health to me mental illness.

long history

The journey that led to the Ness recommendations follows a long history of treatment and research in the field of fecal transplantation.

The first reports of their treatment appear in texts traditional chinese medicine in the fourth century to treat diarrhea, and its first reported modern use was in 1958 when a US Army physician, Ben Eisman, He succeeded in treating soldiers who had diarrhea – Possibly a C diff infection.

Single pockets of fecal culture persisted through the rest of the 20th century, but in the UK, Peter Hooke, Professor of Clinical Bacteriology and Public Health at the University of Birmingham, led the way as a leading academic in understanding various C infections and using FMT as a treatment.

Upon arriving at the University of Birmingham in 2001, Professor Hawke established a manufacturing facility to treat patients at ten regional hospitals in the West Midlands. Shortly thereafter, a serious epidemic infected hospitalized patients in the UK with C diff, resulting in the disease national investigation. However, despite the obvious need for effective treatment, the first transplants were performed only in 2013.

In the same year, a research article The treatment is shown to be an effective alternative compared to antibiotics for the treatment of recurrent C diff infection.

Clostridium difficile bacteria.
History of Science Images / Alamy Stock Photo

In 2016, the Medicines and Healthcare products Regulatory Agency, the UK drug regulator, granted the University of Birmingham a license to start treatment across the UK.

“Special licensing” has enabled fecal transplants to be used outside the manufacturing establishment, and the University of Birmingham Microbiome Therapy Center holds the only such license in the UK public sector at the moment.

Over the past six years, the team has treated hundreds of patients in the UK. In addition to providing relief for hundreds of patients with chronic bowel strictures, we have also used FMT in clinical trials, including First UK pilot study of FMT for the treatment of ulcerative colitisA form of inflammatory bowel disease.

Thus, the recommendation published by Nice this week is an endorsement of a treatment that has been carried out across the UK since 2013 and will improve quality of life for many people with persistent C diff infection.