The Search for Effective Treatment of Clostridium difficile Infection.
N Engl J Med. 2011 Feb 2;
Authors: Dupont HL
Since 1996, the incidence of Clostridium difficile infection has more than doubled. Some estimates suggest that there may be up to 3 million cases each year in the United States. If that statistic is correct, it would make C. difficile infection the most common bacterial cause of diarrhea in the United States. With the rising incidence, we are seeing higher mortality associated with the disease, related to at least two factors: increasing virulence of the C. difficile strains and increasing host vulnerability. C. difficile infection is particularly problematic when three factors are aligned: coexisting conditions, including advanced age; disturbed intestinal . . .
PMID: 21288079 [PubMed - as supplied by publisher]
We are developing a treatment for CDD using a modified faecal bacteriotherapy (MFB) procedure, employing autologous samples collected from the patients prior to their treatment. The samples will be homogenised with saline and filtered. The filtrate will be freeze-dried, placed in enteric coated capsules and used to treat the patient’s CDD. RFID tags will be employed to associate capsules with the patient and assist with sample inventory.
We have demonstrated that freeze drying faecal samples does not markedly reduce their bacterial variety or numbers. Novel plastic containers for processing faecal samples in a more aesthetic way have been produced and an RFID system has been installed.. A market research project has been carried out which concludes that MFB is potentially a safe, inexpensive and effective treatment for CDD. A website http://www.bacteriotherapy.org has been produced which describes the project and includes a copy of the market research report.
We hope to obtain further grant funding to carry out the following procedures (a) to (e) :- (a) Large scale production of plastic containers for sample processing. (b) Testing MFB on a mammalian model. (c) Carrying out a small clinical study of MFB in a hospital infectious diseases unit. (d) Carrying out a large scale comparative clinical trial of MFB.
The outcome should be a safe and inexpensive non-antibiotic medicament to renew a patient’s intestinal flora using autologous samples to prevent or treat CDD. Current therapy for CDD is restricted to only two antibiotics and a parallel allogenic based procedure, we are developing, could be employed to treat populations in the event of a pandemic caused by antibiotic resistant CDD.