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The Faecal Microbiota Transplant

Learn more about faecal microbiota transplant, a methodology used to modify your gut microbiota.
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Clostridium difficile is a type of bacteria that can cause severe infections in the gut. As many as one in 30 of us have C. difficile present in our digestive system. In those with a healthy gut, it can live harmlessly, because the overall population of microbes– known as the microbiota– keep it under control. But if the balance of your microbiota has been damaged– maybe after a routine course of broad=spectrum antibiotics– then C. difficile bacteria can multiply rapidly and produce toxins that make you ill. C. difficile is normally treated with a further course of antibiotics, but because this kills other bacteria in the gut microbiota, the patient will often relapse and become trapped in a cycle of recurrent infections.
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Eventually, antibiotics will stop working altogether. This can have fatal consequences. Of the 15,000 cases of C. difficile infection that are reported in the UK each year, 1,600 will lead to death. That’s why Quadram Institute microbiologists and clinicians at the Norfolk and Norwich University Hospital have come together to deliver an innovative new treatment– faecal microbiota transplants. The transplants involve transferring microbiota from healthy donors into patients with C. difficile infection. The patient receives a whole new, healthier microbiota, leading to immediate benefits. While antibiotic treatment works just 30% of the time, FMT has a 95% success rate in combating recurrent C. difficile, and is less than a tenth of the cost. But this procedure must only be carried out by trained experts.
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Following NICE guidelines, our team has developed the facility to obtain FMT material, screen it for potentially harmful bacteria, and deliver it safely. In the future, we hope to develop FMT to treat other conditions related to the microbiota, such as ulcerative colitis and diabetes. FMT is just one example of the many novel microbiota-based therapies we’re developing in order to bring about innovative change– change that will benefit society and the economy, and improve healthcare in the UK and beyond. The Quadram Institute is at the heart of the Norwich Research Park, looking at the impact of diet and microbes on healthy ageing. Find out more. Visit quadram.ac.uk. [THEME MUSIC]

Our microbiome can protect us against infections, however, antibiotic treatment is one of the most common risk factors for contracting a Clostridium difficile infection (CDI) due to the depletion of microbiome. 20-30% of C. difficile infected patients treated with antibiotics often relapse, setting up a cycle of recurrent infections, leaving them increasingly sicker. Faecal Microbiota Transplants (FMT) break this cycle by replacing the patient’s microbiome with a healthier one, delivering almost immediate health benefits. A number of large clinical trials have proven the effectiveness of FMT for the treatment of CDI.

In Faecal Microbiota Transplants (FMT) microbiota from healthy donors is transferred into patients with C. difficile infections who haven’t responded well to the more established treatment with antibiotics, with a success rate of over 90%.

What Is the Procedure?

The patient stops taking antibiotics is given an enema to empty the bowels and a Nasojejunal (NJ) tube is inserted through the nose by a gastroenterologist. Fresh or previously frozen donor faecal slurry is delivered to the patient via this NJ tube or via colonoscopy. The FMT process takes only 20 minutes.

Let’s watch how it is performed in this video.

Research and the Future

Patients, and their microbiomes, are monitored following the transplants to better understand how they work, and which of the hundreds of different bacterial species are the ones responsible for the benefits. There is interest in using FMT against other conditions related to the microbiome, such as ulcerative colitis and diabetes.

Where is Faecal Microbiota Transplant Carried Out?

An example of this treatment in practice is from Norwich, UK, where the collaboration of scientists and clinicians has implemented this successful new treatment for recurring Clostridium difficile infections. Professor Arjan Narbad, Research Leader, Quadram Institute, developed the facility to obtain, screen and deliver healthy material suitable for FMT. The entire procedure is overseen and managed by Dr Ngozi Elumogo, Consultant Microbiologist and Director of Infection Prevention and Control at Norfolk and Norwich University Hospital.

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The Human Microbiome

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